,in the ,senate of the ,united ,states1 ,september #ag1 #bjah4 ,amendment3 ,that the bill from the ,house of ,representatives 7,h4,r4 #f7 entitled ,an ,act to provide for opioid use disorder prevention1 recovery1 and treatment1 and for other purposes41 do pass with the following ,strike all after the enacting clause and insert the following3 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,opioid ,crisis ,response ,act of #bjah4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,opioid ,crisis ,response ,act,sec4 #ajja4 ,definitions4,subtitle ,a--,reauthorization of ,cures ,funding,sec4 #aaja4 ,state response to the opioid abuse crisis4,subtitle ,b--,research and ,innovation,sec4 #abja4 ,advancing cutting-edge research4,sec4 #abjb4 ,pain research4,sec4 #abjc4 ,report on synthetic drug use4,subtitle ,c--,medical ,products and ,controlled ,substances ,safety,sec4 #acja4 ,clarifying ,,fda regulation of non-addictive pain products4,sec4 #acjb4 ,clarifying ,,fda packaging authorities4,sec4 #acjc4 ,strengthening ,,fda and ,,cbp coordination and capacity4,sec4 #acjd4 ,clarifying ,,fda post-market authorities4,sec4 #acje4 ,restricting entrance of illicit drugs4,sec4 #acjf4 ,first responder training4,sec4 #acjg4 ,disposal of controlled substances of hospice patients4,sec4 #acjh4 ,,gao study and report on hospice safe drug management4,sec4 #acji4 ,delivery of a controlled substance by a pharmacy to be administered by injection or implantation4,subtitle ,d--,treatment and ,recovery,sec4 #adja4 ,comprehensive opioid recovery centers4,sec4 #adjb4 ,program to support coordination and continuation of care for drug overdose patients4,sec4 #adjc4 ,alternatives to opioids4,sec4 #adjd4 ,building communities of recovery4,sec4 #adje4 ,peer support technical assistance center4,sec4 #adjf4 ,medication-assisted treatment for recovery from addiction4,sec4 #adjg4 ,grant program4,sec4 #adjh4 ,allowing for more flexibility with respect to medication-assisted treatment for opioid use disorders4,sec4 #adji4 ,national recovery housing best practices4,sec4 #adaj4 ,addressing economic and workforce impacts of the opioid crisis4,sec4 #adaa4 ,career ,act4,sec4 #adab4 ,pilot program to help individuals in recovery from a substance use disorder become stably housed4,sec4 #adac4 ,youth prevention and recovery4,sec4 #adad4 ,plans of safe care4,sec4 #adae4 ,regulations relating to special registration for telemedicine4,sec4 #adaf4 ,national ,health ,service ,corps behavioral and mental health professionals providing obligated service in schools and other community-based settings4,sec4 #adag4 ,loan repayment for substance use disorder treatment providers4,sec4 #adah4 ,protecting moms and infants4,sec4 #adai4 ,early interventions for pregnant women and infants4,sec4 #adbj4 ,report on investigations regarding parity in mental health and substance use disorder benefits4,subtitle ,e--,prevention,sec4 #aeja4 ,study on prescribing limits4,sec4 #aejb4 ,programs for health care workforce4,sec4 #aejc4 ,education and awareness campaigns4,sec4 #aejd4 ,enhanced controlled substance overdoses data collection1 analysis1 and dissemination4,sec4 #aeje4 ,preventing overdoses of controlled substances4,sec4 #aejf4 ,,cdc surveillance and data collection for child1 youth1 and adult trauma4,sec4 #aejg4 ,reauthorization of ,,nasper4,sec4 #aejh4 ,jessie's law4,sec4 #aeji4 ,development and dissemination of model training programs for substance use disorder patient records4,sec4 #aeaj4 ,communication with families during emergencies4,sec4 #aeaa4 ,prenatal and postnatal health4,sec4 #aeab4 ,surveillance and education regarding infections associated with illicit drug use and other risk factors4,sec4 #aeac4 ,task force to develop best practices for trauma-informed identification1 referral1 and support4,sec4 #aead4 ,grants to improve trauma support services and mental health care for children and youth in educational settings4,sec4 #aeae4 ,national ,child ,traumatic ,stress ,initiative4,sec4 #aeaf4 ,national milestones to measure success in curtailing the opioid crisis4,,title ,,ii--,finance,sec4 #bjja4 ,short title4,subtitle ,a--,medicare,sec4 #baja4 ,medicare opioid safety education4,sec4 #bajb4 ,expanding the use of telehealth services for the treatment of opioid use disorder and other substance use disorders4,sec4 #bajc4 ,comprehensive screenings for seniors4,sec4 #bajd4 ,every prescription conveyed securely4,sec4 #baje4 ,standardizing electronic prior authorization for safe prescribing4,sec4 #bajf4 ,strengthening partnerships to prevent opioid abuse4,sec4 #bajg4 ,commit to opioid medical prescriber accountability and safety for seniors4,sec4 #bajh4 ,fighting the opioid epidemic with sunshine4,sec4 #baji4 ,demonstration testing coverage of certain services furnished by opioid treatment programs4,sec4 #baaj4 ,encouraging appropriate prescribing under ,medicare for victims of opioid overdose4,sec4 #baaa4 ,automatic escalation to external review under a ,medicare part ,d drug management program for at-risk beneficiaries4,sec4 #baab4 ,testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology4,sec4 #baac4 ,medicare ,improvement ,fund4,subtitle ,b--,medicaid,sec4 #bbja4 ,caring recovery for infants and babies4,sec4 #bbjb4 ,peer support enhancement and evaluation review4,sec4 #bbjc4 ,medicaid substance use disorder treatment via telehealth4,sec4 #bbjd4 ,enhancing patient access to non-opioid treatment options4,sec4 #bbje4 ,assessing barriers to opioid use disorder treatment4,sec4 #bbjf4 ,help for moms and babies4,sec4 #bbjg4 ,securing flexibility to treat substance use disorders4,sec4 #bbjh4 ,,macpac study and report on ,,mat utilization controls under ,state ,medicaid programs4,sec4 #bbji4 ,opioid addiction treatment programs enhancement4,sec4 #bbaj4 ,better data sharing to combat the opioid crisis4,sec4 #bbaa4 ,mandatory reporting with respect to adult behavioral health measures4,sec4 #bbab4 ,report on innovative ,state initiatives and strategies to provide housing-related services and supports to individuals struggling with substance use disorders under ,medicaid4,sec4 #bbac4 ,technical assistance and support for innovative ,state strategies to provide housing-related supports under ,medicaid4,subtitle ,c--,human ,services,sec4 #bcja4 ,supporting family-focused residential treatment4,sec4 #bcjb4 ,improving recovery and reunifying families4,sec4 #bcjc4 ,building capacity for family-focused residential treatment4,subtitle ,d--,synthetics ,trafficking and ,overdose ,prevention,sec4 #bdja4 ,short title4,sec4 #bdjb4 ,customs fees4,sec4 #bdjc4 ,mandatory advance electronic information for postal shipments4,sec4 #bdjd4 ,international postal agreements4,sec4 #bdje4 ,cost recoupment4,sec4 #bdjf4 ,development of technology to detect illicit narcotics4,sec4 #bdjg4 ,civil penalties for postal shipments4,sec4 #bdjh4 ,report on violations of arrival1 reporting1 entry1 and clearance requirements and falsity or lack of manifest4,sec4 #bdji4 ,effective date2 regulations4,,title ,,iii--,judiciary,subtitle ,a--,access to ,increased ,drug ,disposal,sec4 #caja4 ,short title4,sec4 #cajb4 ,definitions4,sec4 #cajc4 ,authority to make grants4,sec4 #cajd4 ,application4,sec4 #caje4 ,use of grant funds4,sec4 #cajf4 ,eligibility for grant4,sec4 #cajg4 ,duration of grants4,sec4 #cajh4 ,accountability and oversight4,sec4 #caji4 ,duration of program4,sec4 #caaj4 ,authorization of appropriations4,subtitle ,b--,using ,data ,to ,prevent ,opioid ,diversion,sec4 #cbja4 ,short title4,sec4 #cbjb4 ,purpose4,sec4 #cbjc4 ,amendments4,sec4 #cbjd4 ,report4,subtitle ,c--,substance ,abuse ,prevention,sec4 #ccja4 ,short title4,sec4 #ccjb4 ,reauthorization of the ,office of ,national ,drug ,control ,policy4,sec4 #ccjc4 ,reauthorization of the ,drug-,free ,communities ,program4,sec4 #ccjd4 ,reauthorization of the ,national ,community ,anti-,drug ,coalition ,institute4,sec4 #ccje4 ,reauthorization of the ,high-,intensity ,drug ,trafficking ,area ,program4,sec4 #ccjf4 ,reauthorization of drug court program4,sec4 #ccjg4 ,drug court training and technical assistance4,sec4 #ccjh4 ,drug overdose response strategy4,sec4 #ccji4 ,protecting law enforcement officers from accidental exposure4,sec4 #ccaj4 ,,cops ,anti-,meth ,program4,sec4 #ccaa4 ,,cops anti-heroin task force program4,sec4 #ccab4 ,comprehensive ,addiction and ,recovery ,act education and awareness4,sec4 #ccac4 ,protecting children with addicted parents4,sec4 #ccad4 ,reimbursement of substance use disorder treatment professionals4,sec4 #ccae4 ,sobriety ,treatment and ,recovery ,teams 7,,start74,sec4 #ccaf4 ,provider education4,sec4 #ccag4 ,demand reduction4,sec4 #ccah4 ,anti-drug media campaign4,sec4 #ccai4 ,technical corrections to the office of national drug control policy reauthorization act of #aiih4,subtitle ,d--,synthetic ,abuse and ,labeling of ,toxic ,substances,sec4 #cdja4 ,short title4,sec4 #cdjb4 ,controlled substance analogues4,subtitle ,e--,opioid ,quota ,reform,sec4 #ceja4 ,short title4,sec4 #cejb4 ,strengthening considerations for ,,dea opioid quotas4,subtitle ,f--,preventing ,drug ,diversion,sec4 #cfja4 ,short title4,sec4 #cfjb4 ,improvements to prevent drug diversion4,subtitle ,g--,sense of ,congress,sec4 #cgja4 ,sense of ,congress4,,title ,,iv--,commerce,subtitle ,a--,fighting ,opioid ,abuse in ,transportation,sec4 #daja4 ,short title4,sec4 #dajb4 ,rail mechanical employee controlled substances and alcohol testing4,sec4 #dajc4 ,rail yardmaster controlled substances and alcohol testing4,sec4 #dajd4 ,department of ,transportation public drug and alcohol testing database4,sec4 #daje4 ,,gao report on ,department of ,transportation's collection and use of drug and alcohol testing data4,sec4 #dajf4 ,transportation ,workplace ,drug and ,alcohol ,testing ,program2 addition of fentanyl4,sec4 #dajg4 ,status reports on hair testing guidelines4,sec4 #dajh4 ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs ,using ,oral ,fluid4,sec4 #daji4 ,electronic recordkeeping4,sec4 #daaj4 ,status reports on ,commercial ,driver's ,license ,drug and ,alcohol ,clearinghouse4,subtitle ,b--,opioid ,addiction ,recovery ,fraud ,prevention,sec4 #dbja4 ,short title4,sec4 #dbjb4 ,definitions4,sec4 #dbjc4 ,false or misleading representations with respect to opioid treatment programs and products4 ,i ,opioid ,crisis ,response ,act #ajja4 ,definitions ,in this title-- 7#a7 the terms ,indian ,tribe and tribal organization have the meanings given the terms ,indian tribe and tribal organization in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd72 and 7#b7 the term ,secretary means the ,secretary of ,health and ,human ,services1 unless otherwise specified4 ,a ,reauthorization of ,cures ,funding #aaja4 ,state response to the opioid abuse crisis 7a7 ,in general ,section #ajjc of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by striking the authorization of appropriations under subsection 7b7 to carry out the grant program described in subsection 7c7 and inserting subsection 7h7 to carry out the grant program described in subsection 7b72 and 7,b7 by inserting and ,indian ,tribes after ,states2 7#b7 by striking subsection 7b72 7#c7 by redesignating subsections 7c7 through 7e7 as subsections 7b7 through 7d71 respectively2 7#d7 by redesignating subsection 7f7 as subsection 7j72 7#e7 in subsection 7b71 as so redesignated-- 7,a7 in paragraph 7#a7-- 7i7 in the paragraph heading1 by inserting and ,indian ,tribe after ,state2 7ii7 by striking ,states for the purpose of addressing the opioid abuse crisis within such ,states and inserting ,states and ,indian ,tribes for the purpose of addressing the opioid abuse crisis within such ,states and ,indian ,tribes2 7iii7 by inserting or ,indian ,tribes after preference to ,states2 and 7iv7 by inserting before the period of the second sentence or other ,indian ,tribes1 as applicable2 7,b7 in paragraph 7#b7-- 7i7 in the matter preceding subparagraph 7,a71 by striking to a ,state2 7ii7 in subparagraph 7,a71 by striking ,state2 7iii7 in subparagraph 7,c71 by inserting preventing diversion of controlled substances1 after treatment programs12 and 7iv7 in subparagraph 7,e71 by striking as the ,state determines appropriate1 related to addressing the opioid abuse crisis within the ,state and inserting as the ,state or ,indian ,tribe determines appropriate1 related to addressing the opioid abuse crisis within the ,state1 including directing resources in accordance with local needs related to substance use disorders2 7#f7 in subsection 7c71 as so redesignated1 by striking subsection 7c7 and inserting subsection 7b72 7#g7 in subsection 7d71 as so redesignated-- 7,a7 in the matter preceding paragraph 7#a71 by striking the authorization of appropriations under subsection 7b7 and inserting subsection 7h72 and 7,b7 in paragraph 7#a71 by striking subsection 7c7 and inserting subsection 7b72 and 7#h7 by inserting after subsection 7d71 as so redesignated1 the following3 7e7 ,indian ,tribes 7#a7 ,definition ,for purposes of this section1 the term ,indian ,tribe has the meaning given the term ,indian tribe in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#b7 ,appropriate mechanisms ,the ,secretary1 in consultation with ,indian ,tribes1 shall identify and establish appropriate mechanisms for ,tribes to demonstrate or report the information as required under subsections 7b71 7c71 and 7d74 7f7 ,report to ,congress ,not later than #a year after the date on which amounts are first awarded after the date of enactment of the ,opioid ,crisis ,response ,act of #bjah1 pursuant to subsection 7b71 and annually thereafter1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report summarizing the information provided to the ,secretary in reports made pursuant to subsection 7c71 including the purposes for which grant funds are awarded under this section and the activities of such grant recipients4 7g7 ,technical ,assistance ,the ,secretary1 including through the ,tribal ,training and ,technical ,assistance ,center of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall provide ,state agencies and ,indian ,tribes1 as applicable1 with technical assistance concerning grant application and submission procedures under this section1 award management activities1 and enhancing outreach and direct support to rural and underserved communities and providers in addressing the opioid crisis4 7h7 ,authorization of appropriations ,for purposes of carrying out the grant program under subsection 7b71 there is authorized to be appropriated #ejj1jjj1jjj for each of fiscal years #bjai through #bjba1 to remain available until expended4 7i7 ,set aside ,of the amounts made available for each fiscal year to award grants under subsection 7b7 for a fiscal year1 #e percent of such amount for such fiscal year shall be made available to ,indian ,tribes1 and up to #ae percent of such amount for such fiscal year may be set aside for ,states with the highest age-adjusted rate of drug overdose death based on the ordinal ranking of ,states according to the ,director of the ,centers for ,disease ,control and ,prevention4 4 7b7 ,conforming amendment ,section #ajjd7;c7 of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 is amended by striking 1 the ,,fda ,innovation ,account1 or the ,account ,for the ,state ,response to the ,opioid ,abuse ,crisis and inserting or the ,,fda ,innovation ,account4 ,b ,research and ,innovation #abja4 ,advancing cutting-edge research ,section #djb7n77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhb7n77#a77 is amended-- 7#a7 in subparagraph 7,a71 by striking or2 7#b7 in subparagraph 7,b71 by striking the period and inserting 2 or2 and 7#c7 by adding at the end the following3 7,c7 high impact cutting-edge research that fosters scientific creativity and increases fundamental biological understanding leading to the prevention1 diagnosis1 or treatment of diseases and disorders1 or research urgently required to respond to a public health threat4 4 #abjb4 ,pain research ,section #dji;,j7b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhdq7b77 is amended-- 7#a7 in paragraph 7#e7-- 7,a7 in subparagraph 7,a71 by striking and treatment of pain and diseases and disorders associated with pain and inserting treatment1 and management of pain and diseases and disorders associated with pain1 including information on best practices for utilization of non-pharmacologic treatments1 non-addictive medical products1 and other drugs or devices approved or cleared by the ,food and ,drug ,administration2 7,b7 in subparagraph 7,b71 by striking on the symptoms and causes of pain2 and inserting the following3 8on-- 7i7 the symptoms and causes of pain1 including the identification of relevant biomarkers and screening models and the epidemiology of acute and chronic pain2 7ii7 the diagnosis1 prevention1 treatment1 and management of acute or chronic pain1 including with respect to non-pharmacologic treatments1 non-addictive medical products1 and other drugs or devices approved or cleared by the ,food and ,drug ,administration2 and 7iii7 risk factors for1 and early warning signs of1 substance use disorders2 and 2 and 7,c7 by striking subparagraphs 7,c7 through 7,e7 and inserting the following3 7,c7 make recommendations to the ,director of ,,nih-- 7i7 to ensure that the activities of the ,national ,institutes of ,health and other ,federal agencies are free of unnecessary duplication of effort2 7ii7 on how best to disseminate information on pain care and epidemiological data related to acute and chronic pain2 and 7iii7 on how to expand partnerships between public entities and private entities to expand collaborative1 cross-cutting research4 2 7#b7 by redesignating paragraph 7#f7 as paragraph 7#g72 and 7#c7 by inserting after paragraph 7#e7 the following3 7#f7 ,report ,the ,director of ,,nih shall ensure that recommendations and actions taken by the ,director with respect to the topics discussed at the meetings described in paragraph 7#d7 are included in appropriate reports to ,congress4 4 #abjc4 ,report on synthetic drug use 7a7 ,in general ,not later than #c years after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report on the health effects of new psychoactive substances1 including synthetic drugs1 by adolescents and young adults4 7b7 ,new psychoactive substance defined ,for purposes of subsection 7a71 the term new psychoactive substance means a controlled substance analogue 7as defined in section #ajb7cb7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7cb7774 ,c ,medical ,products and ,controlled ,substances ,safety #acja4 ,clarifying ,,fda regulation of non-addictive pain products 7a7 ,public ,meetings ,not later than one year after the date of enactment of this ,act1 the ,secretary1 acting through the ,commissioner of ,food and ,drugs1 shall hold not less than one public meeting to address the challenges and barriers of developing non-addictive medical products intended to treat pain or addiction1 which may include-- 7#a7 the manner by which the ,secretary may incorporate the risks of misuse and abuse of a controlled substance 7as defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7 into the risk benefit assessments under subsections 7d7 and 7e7 of section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee71 section #eaj7k7 of such ,act 7#ba ,u4,s4,c4 #cfj7k771 or section #eae7;c7 of such ,act 7#ba ,u4,s4,c4 #cfj;e7c771 as applicable2 7#b7 the application of novel clinical trial designs 7consistent with section #cjba of the #bast ,century ,cures ,act 7,public ,law #aad-bee771 use of real world evidence 7consistent with section #eje;,f of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;g771 and use of patient experience data 7consistent with section #efi;,c of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cfj;bbb-#h;c77 for the development of non-addictive medical products intended to treat pain or addiction2 7#c7 the evidentiary standards and the development of opioid sparing data for inclusion in the labeling of medical products2 and 7#d7 the application of eligibility criteria under sections #ejf and #eae;,b of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cef1 #cfj;e-#c7 for non-addictive medical products intended to treat pain or addiction4 7b7 ,guidance ,not less than one year after the public meetings are conducted under subsection 7a7 the ,secretary shall issue one or more final guidance documents1 or update existing guidance documents1 to help address challenges to developing non-addictive medical products to treat pain or addiction4 ,such guidance documents shall include information regarding-- 7#a7 how the ,food and ,drug ,administration may apply sections #ejf and #eae;,b of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cef1 #cfj;e-#c7 to non-addictive medical products intended to treat pain or addiction1 including the circumstances under which the ,secretary-- 7,a7 may apply the eligibility criteria under such sections #ejf and #eae;,b to non-addictive medical products intended to treat pain or addiction2 7,b7 considers the risk of addiction of controlled substances approved to treat pain when establishing unmet medical need2 and 7,c7 considers pain1 pain control1 or pain management in assessing whether a disease or condition is a serious or life-threatening disease or condition2 7#b7 the methods by which sponsors may evaluate acute and chronic pain1 endpoints for non-addictive medical products intended to treat pain1 the manner in which endpoints and evaluations of efficacy will be applied across and within review divisions1 taking into consideration the etiology of the underlying disease1 and the manner in which sponsors may use surrogate endpoints1 intermediate endpoints1 and real world evidence2 7#c7 the manner in which the ,food and ,drug ,administration will assess evidence to support the inclusion of opioid sparing data in the labeling of non-addictive medical products intended to treat pain1 including-- 7,a7 data collection methodologies1 including the use of novel clinical trial designs 7consistent with section #cjba of the #bast ,century ,cures ,act 7,public ,law #aad-bee77 and real world evidence 7consistent with section #eje;,f of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;g771 as appropriate1 to support product labeling2 7,b7 ethical considerations of exposing subjects to controlled substances in clinical trials to develop opioid sparing data and considerations on data collection methods that reduce harm1 which may include the reduction of opioid use as a clinical benefit2 7,c7 endpoints1 including primary1 secondary1 and surrogate endpoints1 to evaluate the reduction of opioid use2 7,d7 best practices for communication between sponsors and the agency on the development of data collection methods1 including the initiation of data collection2 and 7,e7 the appropriate format in which to submit such data results to the ,secretary2 and 7#d7 the circumstances under which the ,food and ,drug ,administration considers misuse and abuse of a controlled substance 7as defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7 in making the risk benefit assessment under paragraphs 7#b7 and 7#d7 of subsection 7d7 of section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 and in finding that a drug is unsafe under paragraph 7#a7 or 7#b7 of subsection 7e7 of such section4 7c7 ,definitions ,in this section-- 7#a7 the term medical product means a drug 7as defined in section #bja7;g77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba7;g77#a7771 biological product 7as defined in section #cea7;i7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb7;i7771 or device 7as defined in section #bja7;h7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba7;h7772 and 7#b7 the term opioid sparing means reducing1 replacing1 or avoiding the use of opioids or other controlled substances4 #acjb4 ,clarifying ,,fda packaging authorities 7a7 ,additional potential elements of strategy ,section #eje-a7;e7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7;e77 is amended by adding at the end the following3 7#d7 ,packaging and disposal ,the ,secretary may require a risk evaluation mitigation strategy for a drug for which there is a serious risk of an adverse drug experience described in subparagraph 7,b7 or 7,c7 of subsection 7b77#a71 taking into consideration the factors described in subparagraphs 7,c7 and 7,d7 of subsection 7f77#b7 and in consultation with other relevant ,federal agencies with authorities over drug packaging1 which may include requiring that-- 7,a7 the drug be made available for dispensing to certain patients in unit dose packaging1 packaging that provides a set duration1 or another packaging system that the ,secretary determines may mitigate such serious risk2 or 7,b7 the drug be dispensed to certain patients with a safe disposal packaging or safe disposal system for purposes of rendering drugs non-retrievable 7as defined in section #acjj4je of title #ba1 ,code of ,federal ,regulations 7or any successor regulation77 if the ,secretary has determines that such safe disposal packaging or system may mitigate such serious risk and exists in sufficient quantities4 4 7b7 ,assuring access and minimizing burden ,section #eje-a7;f77#b77;,c7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7;f77#b77;,c77 is amended-- 7#a7 in clause 7i7 by striking and at the end2 and 7#b7 by adding at the end the following3 7iii7 patients with functional needs2 and 4 7c7 ,application to abbreviated new drug applications ,section #eje-a7;i7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7;i77 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 by redesignating subparagraph 7,b7 as subparagraph 7,c72 and 7,b7 inserting after subparagraph 7,a7 the following3 7,b7 ,a packaging or disposal requirement1 if required under subsection 7e77#d7 for the applicable listed drug4 2 and 7#b7 in paragraph 7#b7-- 7,a7 in subparagraph 7,a71 by striking and at the end2 7,b7 by redesignating subparagraph 7,b7 as subparagraph 7,c72 and 7,c7 by inserting after subparagraph 7,a7 the following3 7,b7 shall permit packaging systems and safe disposal packaging or safe disposal systems that are different from those required for the applicable listed drug under subsection 7e77#d72 and 4 #acjc4 ,strengthening ,,fda and ,,cbp coordination and capacity 7a7 ,in general ,the ,secretary1 acting through the ,commissioner of ,food and ,drugs1 shall coordinate with the ,secretary of ,homeland ,security to carry out activities related to customs and border protection and response to illegal controlled substances and drug imports1 including at sites of import 7such as international mail facilities74 ,such ,secretaries may carry out such activities through a memorandum of understanding between the ,food and ,drug ,administration and the ,u4,s4 ,customs and ,border ,protection4 7b7 ,,fda import facilities and inspection capacity 7#a7 ,in general ,in carrying out this section1 the ,secretary shall1 in collaboration with the ,secretary of ,homeland ,security and the ,postmaster ,general of the ,united ,states ,postal ,service1 provide that import facilities in which the ,food and ,drug ,administration operates or carries out activities related to drug imports within the international mail facilities include-- 7,a7 facility upgrades and improved capacity in order to increase and improve inspection and detection capabilities1 which may include1 as the ,secretary determines appropriate-- 7i7 improvements to facilities1 such as upgrades or renovations1 and support for the maintenance of existing import facilities and sites to improve coordination between ,federal agencies2 7ii7 the construction of1 or upgrades to1 laboratory capacity for purposes of detection and testing of imported goods2 7iii7 upgrades to the security of import facilities2 and 7iv7 innovative technology and equipment to facilitate improved and near-real-time information sharing between the ,food and ,drug ,administration1 the ,department of ,homeland ,security1 and the ,united ,states ,postal ,service2 and 7,b7 innovative technology1 including controlled substance detection and testing equipment and other applicable technology1 in order to collaborate with the ,u4,s4 ,customs and ,border ,protection to share near-real-time information1 including information about test results1 as appropriate4 7#b7 ,innovative technology ,any technology used in accordance with paragraph 7#a77;,b7 shall be interoperable with technology used by other relevant ,federal agencies1 including the ,u4,s4 ,customs and ,border ,protection1 as the ,secretary determines appropriate4 7c7 ,report ,not later than #f months after the date of enactment of this ,act1 the ,secretary1 in consultation with the ,secretary of ,homeland ,security and the ,postmaster ,general of the ,united ,states ,postal ,service1 shall report to the relevant committees of ,congress on the implementation of this section1 including a summary of progress made towards near-real-time information sharing and the interoperability of such technologies4 7d7 ,authorization of appropriations ,out of amounts otherwise available to the ,secretary1 the ,secretary may allocate such sums as may be necessary for purposes of carrying out this section4 #acjd4 ,clarifying ,,fda post-market authorities ,section #eje-a7;b77#a77;,e7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7;b77#a77;,e77 is amended by striking of the drug and inserting of the drug1 which may include reduced effectiveness under the conditions of use prescribed in the labeling of such drug1 but which may not include reduced effectiveness that is in accordance with such labeling4 #acje4 ,restricting entrance of illicit drugs 7a7 ,in general ,the ,secretary1 acting through the ,commissioner of ,food and ,drugs1 upon discovering or receiving1 in a package being offered for import1 a controlled substance that is offered for import in violation of any requirement of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq471 the ,controlled ,substances ,import and ,export ,act 7#ba ,u4,s4,c4 #iea et seq471 the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cja et seq471 or any other applicable law1 shall transfer such package to the ,u4,s4 ,customs and ,border ,protection4 ,if the ,secretary identifies additional packages that appear to be the same as such package containing a controlled substance1 such additional packages may also be transferred to ,u4,s4 ,customs and ,border ,protection4 ,the ,u4,s4 ,customs and ,border ,protection shall receive such packages consistent with the requirements of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq474 7b7 ,debarment1 temporary denial of approval1 and suspension 7#a7 ,in general ,section #cjf7;b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cce;a7b77 is amended-- 7,a7 in paragraph 7#a7-- 7i7 in the matter preceding subparagraph 7,a71 by inserting or 7#c7 after paragraph 7#b72 7ii7 in subparagraph 7,a71 by striking the comma at the end and inserting a semicolon2 7iii7 in subparagraph 7,b71 by striking 1 or and inserting a semicolon2 7iv7 in subparagraph 7,c71 by striking the period and inserting 2 or2 and 7v7 by adding at the end the following3 7,d7 a person from importing or offering for import into the ,united ,states a drug4 2 and 7,b7 in paragraph 7#c7-- 7i7 in the heading1 by striking ,food2 7ii7 in subparagraph 7,a71 by striking 2 or and inserting a semicolon2 7iii7 in subparagraph 7,b71 by striking the period and inserting a semicolon2 and 7iv7 by adding at the end the following3 7,c7 the person has been convicted of a felony for conduct relating to the importation into the ,united ,states of any drug or controlled substance 7as defined in section #ajb of the ,controlled ,substances ,act72 7,d7 the person has engaged in a pattern of importing or offering for import-- 7i7 controlled substances that are prohibited from importation under section #dja7m7 of the ,tariff ,act of #aicj 7#ai ,u4,s4,c4 #adja7m772 or 7ii7 adulterated or misbranded drugs that are-- 7,i7 not designated in an authorized electronic data interchange system as a product that is regulated by the ,secretary2 or 7,,ii7 knowingly or intentionally falsely designated in an authorized electronic data interchange system as a product that is regulated by the ,secretary4 4 7#b7 ,prohibited act ,section #cja7;cc7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cca7;cc77 is amended by inserting or a drug after food4 7c7 ,imports and exports ,section #hja7;a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cha7;a77 is amended-- 7#a7 by striking the second sentence2 7#b7 by striking ,if it appears and inserting ,subject to subsection 7b71 if it appears2 7#c7 by striking regarding such article1 then such article shall be refused and inserting the following3 regarding such article1 or 7#e7 such article is being imported or offered for import in violation of section #cja7;cc71 then any such article described in any of clauses 7#a7 through 7#e7 may be refused admission4 ,if it appears from the examination of such samples or otherwise that the article is a counterfeit drug1 such article shall be refused admission42 7#d7 by striking this ,act1 then such article shall be refused admission and inserting this ,act1 then such article may be refused admission2 and 7#e7 by striking ,clause 7#b7 of the third sentence and all that follows through the period at the end and inserting the following3 ,neither clause 7#b7 nor clause 7#e7 of the second sentence of this subsection shall be construed to prohibit the admission of narcotic drugs1 the importation of which is permitted under the ,controlled ,substances ,import and ,export ,act44 7d7 ,certain illicit articles ,section #hja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cha7 is amended by adding at the end the following-- 7t7 ,illicit articles containing active pharmaceutical ingredients 7#a7 ,in general ,for purposes of this section1 an article that is being imported or offered for import into the ,united ,states may be treated by the ,secretary as a drug if the article-- 7,a7 is not-- 7i7 accompanied by an electronic import entry for such article submitted using an authorized electronic data interchange system2 and 7ii7 designated in such a system as an article regulated by the ,secretary 7which may include regulation as a drug1 a device1 or a dietary supplement2 and 7,b7 is an ingredient that presents significant public health concern and is1 or contains-- 7i7 an active ingredient in a drug-- 7,i7 that is approved under section #eje or licensed under section #cea of the ,public ,health ,service ,act2 or 7,,ii7 for which-- 7aa7 an investigational use exemption is in effect under section #eje7;i7 of this ,act or section #cea7;a7 of the ,public ,health ,service ,act2 and 7bb7 a substantial clinical investigation has been instituted1 and such investigation has been made public2 or 7ii7 a substance that has a chemical structure that is substantially similar to the chemical structure of an active ingredient in a drug or biological product described in subclause 7,i7 or 7,,ii7 of clause 7i74 7#b7 ,effect ,this subsection shall not be construed to bear upon any determination of whether an article is a drug within the meaning of section #bja7;g71 other than for the purposes described in paragraph 7#a74 4 #acjf4 ,first responder training ,section #edf of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#a7 is amended-- 7#a7 in subsection 7c7-- 7,a7 in paragraph 7#b71 by striking and at the end2 7,b7 in paragraph 7#c71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#d7 train and provide resources for first responders and members of other key community sectors on safety around fentanyl1 carfentanil1 and other dangerous licit and illicit drugs to protect themselves from exposure to such drugs and respond appropriately when exposure occurs4 2 7#b7 in subsection 7d71 by striking and mechanisms for referral to appropriate treatment for an entity receiving a grant under this section and inserting mechanisms for referral to appropriate treatment1 and safety around fentanyl1 carfentanil1 and other dangerous licit and illicit drugs2 7#c7 in subsection 7f7-- 7,a7 in paragraph 7#c71 by striking and at the end2 7,b7 in paragraph 7#d71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#e7 the number of first responders and members of other key community sectors trained on safety around fentanyl1 carfentanil1 and other dangerous licit and illicit drugs4 2 7#d7 by redesignating subsection 7g7 as subsection 7h72 7#e7 by inserting after subsection 7f7 the following3 7g7 ,other key community sectors ,in this section1 the term other key community sectors includes substance abuse treatment providers1 emergency medical services agencies1 agencies and organizations working with prison and jail populations and offender reentry programs1 health care providers1 harm reduction groups1 pharmacies1 community health centers1 tribal health facilities1 and mental health providers4 2 and 7#f7 in subsection 7h71 as so redesignated1 by striking #ab1jjj1jjj for each of fiscal years #bjag through #bjba and inserting #cf1jjj1jjj for each of fiscal years #bjai through #bjbc4 #acjg4 ,disposal of controlled substances of hospice patients 7a7 ,in general ,section #cjb7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbb7;g77 is amended by adding at the end the following3 7#e7 7,a7 ,an employee of a qualified hospice program acting within the scope of employment may handle1 in the place of residence of a hospice patient1 any controlled substance that was lawfully dispensed to the hospice patient1 for the purpose of assisting in the disposal of the controlled substance-- 7i7 after the hospice patient's death2 7ii7 if the controlled substance is expired2 or 7iii7 if-- 7,i7 the employee is-- 7aa7 the physician of the hospice patient2 and 7bb7 registered under section #cjc7;f72 and 7,,ii7 the hospice patient no longer requires the controlled substance because the plan of care of the hospice patient has been modified4 7,b7 ,in this paragraph3 7i7 ,the term employee of a qualified hospice program means a physician1 physician assistant1 registered nurse1 or nurse practitioner who-- 7,i7 is employed by1 or is acting pursuant to arrangements made with1 a qualified hospice program2 and 7,,ii7 is licensed or certified to perform such employment1 or such activities arranged by the qualified hospice program1 in accordance with applicable ,state law4 7ii7 ,the terms hospice care and hospice program have the meanings given those terms in section #ahfa7;dd7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd774 7iii7 ,the term hospice patient means an individual receiving hospice care4 7iv7 ,the term qualified hospice program means a hospice program that-- 7,i7 has written policies and procedures for employees of the hospice program to use when assisting in the disposal of the controlled substances of a hospice patient in a circumstance described in clause 7i71 7ii71 or 7iii7 of subparagraph 7,a72 7,,ii7 at the time when the controlled substances are first ordered-- 7aa7 provides a copy of the written policies and procedures to the hospice patient or hospice patient representative and the family of the hospice patient2 7bb7 discusses the policies and procedures with the hospice patient or hospice patient's representative and the hospice patient's family in a language and manner that such individuals understand to ensure that such individuals are informed regarding the safe disposal of controlled substances2 and 7cc7 documents in the clinical record of the hospice patient that the written policies and procedures were provided and discussed with the hospice patient or hospice patient's representative2 and 7,,iii7 at the time when an employee of the hospice program assists in the disposal of controlled substances of a hospice patient1 documents in the clinical record of the hospice patient a list of all controlled substances disposed of4 7,c7 ,the ,attorney ,general may1 by regulation1 include additional types of licensed medical professionals in the definition of the term employee of a qualified hospice program under subparagraph 7,b74 4 7b7 ,no registration required ,section #cjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbb7;c77 is amended by adding at the end the following3 7#d7 ,an employee of a qualified hospice program for the purpose of assisting in the disposal of a controlled substance in accordance with subsection 7g77#e71 except as provided in subparagraph 7,a77iii7 of that subsection4 4 7c7 ,guidance ,the ,attorney ,general may issue guidance to qualified hospice programs to assist the programs in satisfying the requirements under paragraph 7#e7 of section #cjb7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbb7;g771 as added by subsection 7a74 7d7 ,state and local authority ,nothing in this section or the amendments made by this section shall be construed to prevent a ,state or local government from imposing additional controls or restrictions relating to the regulation of the disposal of controlled substances in hospice care or hospice programs4 #acjh4 ,,gao study and report on hospice safe drug management 7a7 ,study 7#a7 ,in general ,the ,comptroller ,general of the ,united ,states 7in this section referred to as the ,comptroller ,general7 shall conduct a study on the requirements applicable to and challenges of hospice programs with regard to the management and disposal of controlled substances in the home of an individual4 7#b7 ,contents ,in conducting the study under paragraph 7#a71 the ,comptroller ,general shall include-- 7,a7 an overview of challenges encountered by hospice programs regarding the disposal of controlled substances1 such as opioids1 in a home setting1 including any key changes in policies1 procedures1 or best practices for the disposal of controlled substances over time2 and 7,b7 a description of ,federal requirements1 including requirements under the ,medicare program1 for hospice programs regarding the disposal of controlled substances in a home setting1 and oversight of compliance with those requirements4 7b7 ,report ,not later than #ah months after the date of enactment of this ,act1 the ,comptroller ,general shall submit to ,congress a report containing the results of the study conducted under subsection 7a71 together with recommendations1 if any1 for such legislation and administrative action as the ,comptroller ,general determines appropriate4 #acji4 ,delivery of a controlled substance by a pharmacy to be administered by injection or implantation 7a7 ,in general ,the ,controlled ,substances ,act is amended by inserting after section #cji 7#ba ,u4,s4,c4 #hbi7 the following3 #cji;,a4 ,delivery of a controlled substance by a pharmacy to an administering practitioner 7a7 ,in general ,notwithstanding section #ajb7aj71 a pharmacy may deliver a controlled substance to a practitioner in accordance with a prescription that meets the requirements of this title and the regulations issued by the ,attorney ,general under this title1 for the purpose of administering the controlled substance by the practitioner if-- 7#a7 the controlled substance is delivered by the pharmacy to the prescribing practitioner or the practitioner administering the controlled substance1 as applicable1 at the location listed on the practitioner's certificate of registration issued under this title2 7#b7 in the case of administering of the controlled substance for the purpose of maintenance or detoxification treatment under section #cjc7;g77#b7-- 7,a7 the practitioner who issued the prescription is a qualifying practitioner authorized under1 and acting within the scope of that section2 and 7,b7 the controlled substance is to be administered by injection or implantation2 7#c7 the pharmacy and the practitioner are authorized to conduct the activities specified in this section under the law of the ,state in which such activities take place2 7#d7 the prescription is not issued to supply any practitioner with a stock of controlled substances for the purpose of general dispensing to patients2 7#e7 except as provided in subsection 7b71 the controlled substance is to be administered only to the patient named on the prescription not later than #ad days after the date of receipt of the controlled substance by the practitioner2 and 7#f7 notwithstanding any exceptions under section #cjg1 the prescribing practitioner1 and the practitioner administering the controlled substance1 as applicable1 maintain complete and accurate records of all controlled substances delivered1 received1 administered1 or otherwise disposed of under this section1 including the persons to whom controlled substances were delivered and such other information as may be required by regulations of the ,attorney ,general4 7b7 ,modification of number of days before which controlled substance shall be administered 7#a7 ,initial #b-year period ,during the #b-year period beginning on the date of enactment of this section1 the ,attorney ,general1 in coordination with the ,secretary1 may reduce the number of days described in subsection 7a77#e7 if the ,attorney ,general determines that such reduction will-- 7,a7 reduce the risk of diversion2 or 7,b7 protect the public health4 7#b7 ,modifications after submission of report ,after the date on which the report described in subsection 7c7 is submitted1 the ,attorney ,general1 in coordination with the ,secretary1 may modify the number of days described in subsection 7a77#e74 7#c7 ,minimum number of days ,any modification under this subsection shall be for a period of not less than #g days4 4 7b7 ,study and report ,not later than #b years after the date of enactment of this section1 the ,comptroller ,general of the ,united ,states shall conduct a study and submit to ,congress a report on access to and potential diversion of controlled substances administered by injection or implantation4 7c7 ,technical and conforming amendment ,the table of contents for the ,comprehensive ,drug ,abuse ,prevention and ,control ,act of #aigj is amended by inserting after the item relating to section #cji the following3 ,sec4 #cji;,a4 ,delivery of a controlled substance by a pharmacy to an administering practitioner4 4 ,d ,treatment and ,recovery #adja4 ,comprehensive opioid recovery centers 7a7 ,in general ,the ,secretary shall award grants on a competitive basis to eligible entities to establish or operate a comprehensive opioid recovery center 7referred to in this section as a ,center74 ,a ,center may be a single entity or an integrated delivery network4 7b7 ,grant period 7#a7 ,in general ,a grant awarded under subsection 7a7 shall be for a period not more than #e years4 7#b7 ,renewal ,a grant awarded under subsection 7a7 may be renewed1 on a competitive basis1 for additional periods of time1 as determined by the ,secretary4 ,in determining whether to renew a grant under this paragraph1 the ,secretary shall consider the data submitted under subsection 7h74 7c7 ,minimum number of grants ,the ,secretary shall allocate the amounts made available under subsection 7j7 such that not fewer than #aj grants may be awarded4 ,not more than one grant shall be made to entities in a single ,state for any one period4 7d7 ,application 7#a7 ,eligible entity ,an entity is eligible for a grant under this section if the entity offers treatment and other services for individuals with a substance use disorder4 7#b7 ,submission of application ,in order to be eligible for a grant under subsection 7a71 an entity shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 ,such application shall include-- 7,a7 evidence that such entity carries out1 or is capable of coordinating with other entities to carry out1 the activities described in subsection 7g72 and 7,b7 such other information as the ,secretary may require4 7e7 ,priority ,in awarding grants under subsection 7a71 the ,secretary shall give priority to eligible entities located in a ,state or ,indian ,tribe with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention4 7f7 ,preference ,in awarding grants under subsection 7a71 the ,secretary may give preference to eligible entities utilizing technology-enabled collaborative learning and capacity building models1 including such models as defined in section #b of the ,expanding ,capacity for ,health ,outcomes ,act 7,public ,law #aad-bgj2 #acj ,stat4 #acie71 to conduct the activities described in this section4 7g7 ,center activities ,each ,center shall1 at a minimum1 carry out the following activities directly1 through referral1 or through contractual arrangements1 which may include carrying out such activities through technology-enabled collaborative learning and capacity building models described in subsection 7f73 7#a7 ,treatment and recovery services ,each ,center shall-- 7,a7 ensure that intake and evaluations meet the individualized clinical needs of patients1 including by offering assessments for services and care recommendations through independent1 evidence-based verification processes for reviewing patient placement in treatment settings2 7,b7 provide the full continuum of treatment services1 including-- 7i7 all drugs approved by the ,food and ,drug ,administration to treat substance use disorders1 pursuant to ,federal and ,state law2 7ii7 medically supervised withdrawal management that includes patient evaluation1 stabilization1 and readiness for and entry into treatment2 7iii7 counseling provided by a program counselor or other certified professional who is licensed and qualified by education1 training1 or experience to assess the psychological and sociological background of patients1 to contribute to the appropriate treatment plan for the patient1 and to monitor patient progress2 7iv7 treatment1 as appropriate1 for patients with co-occurring substance use and mental disorders2 7v7 testing1 as appropriate1 for infections commonly associated with illicit drug use2 7vi7 residential rehabilitation1 and outpatient and intensive outpatient programs2 7vii7 recovery housing2 7viii7 community-based and peer recovery support services2 7ix7 job training1 job placement assistance1 and continuing education assistance to support reintegration into the workforce2 and 7x7 other best practices to provide the full continuum of treatment and services1 as determined by the ,secretary2 7,c7 ensure that all programs covered by the ,center include medication-assisted treatment1 as appropriate1 and do not exclude individuals receiving medication-assisted treatment from any service2 7,d7 periodically conduct patient assessments to support sustained and clinically significant recovery1 as defined by the ,assistant ,secretary for ,mental ,health and ,substance ,use2 7,e7 administer an onsite pharmacy and provide toxicology services1 for purposes of carrying out this section2 and 7,f7 operate a secure1 confidential1 and interoperable electronic health information system4 7#b7 ,outreach ,each ,center shall carry out outreach activities to publicize the services offered through the ,centers1 which may include-- 7,a7 training and supervising outreach staff1 as appropriate1 to work with ,state and local health departments1 health care providers1 the ,indian ,health ,service1 ,state and local educational agencies1 schools funded by the ,indian ,bureau of ,education1 institutions of higher education1 ,state and local workforce development boards1 ,state and local community action agencies1 public safety officials1 first responders1 ,indian ,tribes1 child welfare agencies1 as appropriate1 and other community partners and the public1 including patients1 to identify and respond to community needs2 7,b7 ensuring that the entities described in subparagraph 7,a7 are aware of the services of the ,center2 and 7,c7 disseminating and making publicly available1 including through the internet1 evidence-based resources that educate professionals and the public on opioid use disorder and other substance use disorders1 including co-occurring substance use and mental disorders4 7h7 ,data reporting and program oversight ,with respect to a grant awarded under subsection 7a71 not later than #ij days after the end of the first year of the grant period1 and annually thereafter for the duration of the grant period 7including the duration of any renewal period for such grant71 the entity shall submit data1 as appropriate1 to the ,secretary regarding-- 7#a7 the programs and activities funded by the grant2 7#b7 health outcomes of the population of individuals with a substance use disorder who received services from the ,center1 evaluated by an independent program evaluator through the use of outcomes measures1 as determined by the ,secretary2 7#c7 the retention rate of program participants2 and 7#d7 any other information that the ,secretary may require for the purpose of ensuring that the ,center is complying with all the requirements of the grant1 including providing the full continuum of services described in subsection 7g77#a77;,b74 7i7 ,privacy ,the provisions of this section1 including with respect to data reporting and program oversight1 shall be subject to all applicable ,federal and ,state privacy laws4 7j7 ,authorization of appropriations ,there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjai through #bjbc for purposes of carrying out this section4 7k7 ,reports to ,congress 7#a7 ,preliminary report ,not later than #c years after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a preliminary report that analyzes data submitted under subsection 7h74 7#b7 ,final report ,not later than #b years after submitting the preliminary report required under paragraph 7#a71 the ,secretary shall submit to ,congress a final report that includes-- 7,a7 an evaluation of the effectiveness of the comprehensive services provided by the ,centers established or operated pursuant to this section with respect to health outcomes of the population of individuals with substance use disorder who receive services from the ,center1 which shall include an evaluation of the effectiveness of services for treatment and recovery support and to reduce relapse1 recidivism1 and overdose2 and 7,b7 recommendations1 as appropriate1 regarding ways to improve ,federal programs related to substance use disorders1 which may include dissemination of best practices for the treatment of substance use disorders to health care professionals4 #adjb4 ,program to support coordination and continuation of care for drug overdose patients 7a7 ,in general ,the ,secretary shall identify or facilitate the development of best practices for-- 7#a7 emergency treatment of known or suspected drug overdose2 7#b7 the use of recovery coaches1 as appropriate1 to encourage individuals who experience a non-fatal overdose to seek treatment for substance use disorder and to support coordination and continuation of care2 7#c7 coordination and continuation of care and treatment1 including1 as appropriate1 through referrals1 of individuals after an opioid overdose2 and 7#d7 the provision of overdose reversal medication1 as appropriate4 7b7 ,grant establishment and participation 7#a7 ,in general ,the ,secretary shall award grants on a competitive basis to eligible entities to support implementation of voluntary programs for care and treatment of individuals after an opioid overdose1 as appropriate1 which may include implementation of the best practices described in subsection 7a74 7#b7 ,eligible entity ,in this section1 the term eligible entity means-- 7,a7 a ,state alcohol or drug agency2 7,b7 an ,indian ,tribe or tribal organization2 or 7,c7 an entity that offers treatment or other services for individuals in response to1 or following1 drug overdoses or a drug overdose1 in consultation with a ,state alcohol and drug agency4 7#c7 ,application ,an eligible entity desiring a grant under this section shall submit an application to the ,secretary1 at such time and in such manner as the ,secretary may require1 that includes-- 7,a7 evidence that such eligible entity carries out1 or is capable of contracting and coordinating with other community entities to carry out1 the activities described in paragraph 7#d72 7,b7 evidence that such eligible entity will work with a recovery community organization to recruit1 train1 hire1 mentor1 and supervise recovery coaches and fulfill the requirements described in paragraph 7#d77;,a72 and 7,c7 such additional information as the ,secretary may require4 7#d7 ,use of grant funds ,an eligible entity awarded a grant under this section shall use such grant funds to-- 7,a7 hire or utilize recovery coaches to help support recovery1 including by-- 7i7 connecting patients to a continuum of care services1 such as-- 7,i7 treatment and recovery support programs2 7,,ii7 programs that provide non-clinical recovery support services2 7,,iii7 peer support networks2 7,,iv7 recovery community organizations2 7,v7 health care providers1 including physicians and other providers of behavioral health and primary care2 7,,vi7 education and training providers2 7,,vii7 employers2 7,,viii7 housing services2 and 7,,ix7 child welfare agencies2 7ii7 providing education on overdose prevention and overdose reversal to patients and families1 as appropriate2 7iii7 providing follow-up services for patients after an overdose to ensure continued recovery and connection to support services2 7iv7 collecting and evaluating outcome data for patients receiving recovery coaching services2 and 7v7 providing other services the ,secretary determines necessary to help ensure continued connection with recovery support services1 including culturally appropriate services1 as applicable2 7,b7 establish policies and procedures1 pursuant to ,federal and ,state law1 that address the provision of overdose reversal medication1 the administration of all drugs approved by the ,food and ,drug ,administration to treat substance use disorder1 and subsequent continuation of1 or referral to1 evidence-based treatment for patients with a substance use disorder who have experienced a non-fatal drug overdose1 in order to support long-term treatment1 prevent relapse1 and reduce recidivism and future overdose2 and 7,c7 establish integrated models of care for individuals who have experienced a non-fatal drug overdose which may include patient assessment1 follow up1 and transportation to and from treatment facilities4 7#e7 ,additional permissible uses ,in addition to the uses described in paragraph 7#d71 a grant awarded under this section may be used1 directly or through contractual arrangements1 to provide-- 7,a7 all drugs approved by the ,food and ,drug ,administration to treat substance use disorders1 pursuant to ,federal and ,state law2 7,b7 withdrawal and detoxification services that include patient evaluation1 stabilization1 and preparation for treatment of substance use disorder1 including treatment described in subparagraph 7,a71 as appropriate2 or 7,c7 mental health services provided by a program counselor1 social worker1 therapist1 or other certified professional who is licensed and qualified by education1 training1 or experience to assess the psychosocial background of patients1 to contribute to the appropriate treatment plan for patients with substance use disorder1 and to monitor patient progress4 7#f7 ,preference ,in awarding grants under this section1 the ,secretary shall give preference to eligible entities that meet any or all of the following criteria3 7,a7 ,the eligible entity is a critical access hospital 7as defined in section #ahfa7mm77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm77#a7771 a low volume hospital 7as defined in section #ahhf7;d77#ab77;,c77i7 of such ,act 7#db ,u4,s4,c4 #acieww7d77#ab77;,c77i7771 or a sole community hospital 7as defined in section #ahhf7;d77#e77;,d77iii7 of such ,act 7#db ,u4,s4,c4 #acieww7d77#e77;,d77iii7774 7,b7 ,the eligible entity is located in a ,state1 or under the jurisdiction of an ,indian ,tribe1 with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention4 7,c7 ,the eligible entity demonstrates that recovery coaches will be placed in both health care settings and community settings4 7#g7 ,period of grant ,a grant awarded to an eligible entity under this section shall be for a period of not more than #e years4 7c7 ,definitions ,in this section3 7#a7 ,recovery coach the term recovery coach means an individual-- 7,a7 with knowledge of1 or experience with1 recovery from a substance use disorder2 and 7,b7 who has completed training from1 and is determined to be in good standing by1 a recovery services organization capable of conducting such training and making such determination4 7#b7 ,recovery community organization ,the term recovery community organization has the meaning given such term in section #edg7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b7;a774 7#c7 ,state alcohol and drug agency ,the term ,state alcohol and drug agency means the principal agency of a ,state that is responsible for carrying out the block grant for prevention and treatment of substance abuse under subpart ,,ii of part ,b of title ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ba et seq47 7d7 ,reporting requirements 7#a7 ,reports by grantees ,each eligible entity awarded a grant under this section shall submit to the ,secretary an annual report for each year for which the entity has received such grant that includes information on-- 7,a7 the number of individuals treated by the entity for non-fatal overdoses1 including the number of non-fatal overdoses where overdose reversal medication was administered2 7,b7 the number of individuals administered medication-assisted treatment by the entity2 7,c7 the number of individuals referred by the entity to other treatment facilities after a non-fatal overdose1 the types of such other facilities1 and the number of such individuals admitted to such other facilities pursuant to such referrals2 and 7,d7 the frequency and number of patients with reoccurrences1 including readmissions for non-fatal overdoses and evidence of relapse related to substance use disorder4 7#b7 ,report by ,secretary ,not later than #e years after the date of enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes an evaluation of the effectiveness of the grant program carried out under this section with respect to long term health outcomes of the population of individuals who have experienced a drug overdose1 the percentage of patients treated or referred to treatment by grantees1 and the frequency and number of patients who experienced relapse1 were readmitted for treatment1 or experienced another overdose4 7e7 ,privacy ,the requirements of this section1 including with respect to data reporting and program oversight1 shall be subject to all applicable ,federal and ,state privacy laws4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #adjc4 ,alternatives to opioids 7a7 ,in general ,the ,secretary shall1 directly or through grants to1 or contracts with1 public and private entities1 provide technical assistance to hospitals and other acute care settings on alternatives to opioids for pain management4 ,the technical assistance provided shall be for the purpose of-- 7#a7 utilizing information from acute care providers including emergency departments and other providers that have successfully implemented alternatives to opioids programs1 promoting non-addictive protocols and medications while appropriately limiting the use of opioids2 7#b7 identifying or facilitating the development of best practices on the use of alternatives to opioids1 which may include pain-management strategies that involve non-addictive medical products1 non-pharmacologic treatments1 and technologies or techniques to identify patients at risk for opioid use disorder2 7#c7 identifying or facilitating the development of best practices on the use of alternatives to opioids that target common painful conditions and include certain patient populations1 such as geriatric patients1 pregnant women1 and children2 7#d7 disseminating information on the use of alternatives to opioids to providers in acute care settings1 which may include emergency departments1 outpatient clinics1 critical access hospitals1 ,federally qualified health centers1 ,indian ,health ,service health facilities1 and tribal hospitals2 and 7#e7 collecting data and reporting on health outcomes associated with the use of alternatives to opioids4 7b7 ,pain management and funding 7#a7 ,in general ,the ,secretary shall award grants to hospitals and other acute care settings relating to alternatives to opioids for pain management4 7#b7 ,authorization of appropriations ,there is authorized to be appropriated #e1jjj1jjj for each of fiscal years #bjai through #bjbc for purposes of carrying out this section4 #adjd4 ,building communities of recovery ,section #edg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b7 is amended to read as follows3 #edg4 ,building communities of recovery 7a7 ,definition ,in this section1 the term recovery community organization means an independent nonprofit organization that-- 7#a7 mobilizes resources within and outside of the recovery community1 which may include through a peer support network1 to increase the prevalence and quality of long-term recovery from substance use disorders2 and 7#b7 is wholly or principally governed by people in recovery for substance use disorders who reflect the community served4 7b7 ,grants authorized ,the ,secretary shall award grants to recovery community organizations to enable such organizations to develop1 expand1 and enhance recovery services4 7c7 ,federal share ,the ,federal share of the costs of a program funded by a grant under this section may not exceed #he percent4 7d7 ,use of funds ,grants awarded under subsection 7b7-- 7#a7 shall be used to develop1 expand1 and enhance community and statewide recovery support services2 and 7#b7 may be used to-- 7,a7 build connections between recovery networks1 including between recovery community organizations and peer support networks1 and with other recovery support services1 including-- 7i7 behavioral health providers2 7ii7 primary care providers and physicians2 7iii7 educational and vocational schools2 7iv7 employers2 7v7 housing services2 7vi7 child welfare agencies2 and 7vii7 other recovery support services that facilitate recovery from substance use disorders1 including non-clinical community services2 7,b7 reduce the stigma associated with substance use disorders2 and 7,c7 conduct outreach on issues relating to substance use disorders and recovery1 including-- 7i7 identifying the signs of substance use disorder2 7ii7 the resources available to individuals with substance use disorder and to families of an individual with a substance use disorder1 including programs that mentor and provide support services to children2 7iii7 the resources available to help support individuals in recovery2 and 7iv7 related medical outcomes of substance use disorders1 the potential of acquiring an infection commonly associated with illicit drug use1 and neonatal abstinence syndrome among infants exposed to opioids during pregnancy4 7e7 ,special consideration ,in carrying out this section1 the ,secretary shall give special consideration to the unique needs of rural areas1 including areas with an age-adjusted rate of drug overdose deaths that is above the national average and areas with a shortage of prevention and treatment services4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjai through #bjbc4 4 #adje4 ,peer support technical assistance center 7a7 ,establishment ,the ,secretary1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,abuse1 shall establish or operate a ,national ,peer-,run ,training and ,technical ,assistance ,center for ,addiction ,recovery ,support 7referred to in this subsection as the ,center74 7b7 ,functions ,the ,center established under subsection 7a7 shall provide technical assistance and support to recovery community organizations and peer support networks1 including such assistance and support related to-- 7#a7 training on identifying-- 7,a7 signs of substance use disorder2 7,b7 resources to assist individuals with a substance use disorder1 or resources for families of an individual with a substance use disorder2 and 7,c7 best practices for the delivery of recovery support services2 7#b7 the provision of translation services1 interpretation1 or other such services for clients with limited ,english speaking proficiency2 7#c7 data collection to support research1 including for translational research2 7#d7 capacity building2 and 7#e7 evaluation and improvement1 as necessary1 of the effectiveness of such services provided by recovery community organizations 7as defined in section #edg of the ,public ,health ,service ,act74 7c7 ,best practices ,the ,center established under subsection 7a7 shall periodically issue best practices for use by recovery community organizations and peer support networks4 7d7 ,recovery community organization ,in this section1 the term recovery community organization has the meaning given such term in section #edg of the ,public ,health ,service ,act4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #adjf4 ,medication-assisted treatment for recovery from addiction 7a7 ,waivers for maintenance treatment or detoxification ,section #cjc7;g77#b77;,g77ii7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77ii77 is amended by adding at the end the following3 7,,viii7 ,the physician graduated in good standing from an accredited school of allopathic medicine or osteopathic medicine in the ,united ,states during the #e-year period immediately preceding the date on which the physician submits to the ,secretary a written notification under subparagraph 7,b7 and successfully completed a comprehensive allopathic or osteopathic medicine curriculum or accredited medical residency that-- 7aa7 included not less than #bd hours of training on treating and managing opioid-dependent patients2 and 7bb7 included1 at a minimum-- 7,,aa7 the training described in items 7aa7 through 7gg7 of subclause 7,,iv72 and 7,,bb7 training with respect to any other best practice the ,secretary determines should be included in the curriculum1 which may include training on pain management1 including assessment and appropriate use of opioid and non-opioid alternatives4 4 7b7 ,treatment for children ,the ,secretary shall consider ways to ensure that an adequate number of physicians who meet the requirements under the amendment made by subsection 7a7 and have a specialty in pediatrics1 or the treatment of children or of adolescents1 are granted a waiver under section #cjc7;g77#b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77 to treat children and adolescents with substance use disorders4 7c7 ,technical amendment ,section #ajb7bd7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7bd77 is amended by striking ,health1 ,education1 and ,welfare and inserting ,health and ,human ,services4 #adjg4 ,grant program 7a7 ,in general ,the ,secretary shall establish a grant program under which the ,secretary may make grants to accredited schools of allopathic medicine or osteopathic medicine and teaching hospitals located in the ,united ,states to support the development of curricula that meet the requirements under subclause 7,,viii7 of section #cjc7;g77#b77;,g77ii7 of the ,controlled ,substances ,act1 as added by section #adjf7;a7 of this ,act4 7b7 ,authorization of appropriations ,there is authorized to be appropriated for grants under subsection 7a71 #d1jjj1jjj for each of fiscal years #bjai through #bjbc4 #adjh4 ,allowing for more flexibility with respect to medication-assisted treatment for opioid use disorders ,subclause 7,,ii7 of section #cjc7;g77#b77;,b77iii7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,b77iii77 is amended to read as follows3 7,,ii7 ,the applicable number is-- 7aa7 #ajj if1 not sooner than #a year after the date on which the practitioner submitted the initial notification1 the practitioner submits a second notification to the ,secretary of the need and intent of the practitioner to treat up to #ajj patients2 or 7bb7 #bge if the practitioner meets the requirements specified in section #h4faj of title #db1 ,code of ,federal ,regulations 7or successor regulations74 4 #adji4 ,national recovery housing best practices 7a7 ,best practices for operating recovery housing 7#a7 ,in general ,the ,secretary1 in consultation with the individuals and entities described in paragraph 7#b71 shall identify or facilitate the development of best practices1 which may include model laws for implementing suggested minimum standards1 for operating recovery housing4 7#b7 ,consultation ,in carrying out the activities described in paragraph 7#a7 the ,secretary shall consult with1 as appropriate-- 7,a7 relevant divisions of the ,department of ,health and ,human ,services1 including the ,substance ,abuse and ,mental ,health ,services ,administration1 the ,office of ,inspector ,general1 the ,indian ,health ,service1 and the ,centers for ,medicare ,medicaid ,services2 7,b7 the ,secretary of ,housing and ,urban ,development2 7,c7 directors or commissioners1 as applicable1 of ,state health departments1 tribal health departments1 ,state ,medicaid programs1 and ,state insurance agencies2 7,d7 representatives of health insurance issuers2 7,e7 national accrediting entities and reputable providers of1 and analysts of1 recovery housing services1 including ,indian ,tribes1 tribal organizations1 and tribally designated housing entities that provide recovery housing services1 as applicable2 7,f7 individuals with a history of substance use disorder2 and 7,g7 other stakeholders identified by the ,secretary4 7b7 ,identification of fraudulent recovery housing operators 7#a7 ,in general ,the ,secretary1 in consultation with the individuals and entities described in paragraph 7#b71 shall identify or facilitate the development of common indicators that could be used to identify potentially fraudulent recovery housing operators4 7#b7 ,consultation ,in carrying out the activities described in paragraph 7#a71 the ,secretary shall consult with1 as appropriate-- 7,a7 relevant divisions of the ,department of ,health and ,human ,services1 including the ,substance ,abuse and ,mental ,health ,services ,administration1 the ,office of ,inspector ,general1 the ,indian ,health ,service1 and the ,centers for ,medicare ,medicaid ,services2 7,b7 the ,attorney ,general2 7,c7 the ,secretary of ,housing and ,urban ,development2 7,d7 directors or commissioners1 as applicable1 of ,state health departments1 tribal health departments1 ,state ,medicaid programs1 and ,state insurance agencies2 7,e7 representatives of health insurance issuers2 7,f7 national accrediting entities and reputable providers of1 and analysts of1 recovery housing services1 including ,indian ,tribes1 tribal organizations1 and tribally designated housing entities that provide recovery housing services1 as applicable2 7,g7 individuals with a history of substance use disorder2 and 7,h7 other stakeholders identified by the ,secretary4 7#c7 ,requirements 7,a7 ,practices for identification and reporting ,in carrying out the activities described in this subsection1 the ,secretary shall consider how law enforcement1 public and private payers1 and the public can best identify and report fraudulent recovery housing operators4 7,b7 ,factors to be considered ,in carrying out the activities described in this subsection1 the ,secretary shall consider identifying or developing indicators regarding-- 7i7 unusual billing practices2 7ii7 average lengths of stays2 7iii7 excessive levels of drug testing 7in terms of cost or frequency72 7iv7 unusually high levels of recidivism2 and 7v7 any other factors identified by the ,secretary4 7c7 ,dissemination ,the ,secretary shall1 as appropriate1 disseminate the best practices identified or developed under subsection 7a71 and the common indicators identified or developed under subsection 7b71 to-- 7#a7 ,state agencies1 which may include the provision of technical assistance to ,state agencies seeking to adopt or implement such best practices2 7#b7 ,indian ,tribes1 tribal organizations1 and tribally designated housing entities2 7#c7 the ,attorney ,general2 7#d7 the ,secretary of ,labor2 7#e7 the ,secretary of ,housing and ,urban ,development2 7#f7 ,state and local law enforcement agencies2 7#g7 health insurance issuers2 7#h7 recovery housing entities2 and 7#i7 the public4 7d7 ,requirements ,in carrying out the activities under subsections 7a7 and 7b71 the ,secretary1 in consultation with appropriate stakeholders as described in each such subsection1 shall consider how recovery housing is able to support recovery and prevent relapse1 recidivism1 or overdose 7including overdose death71 including by improving access and adherence to treatment1 including medication-assisted treatment4 7e7 ,rule of construction ,nothing in this section shall be construed to provide the ,secretary with the authority to require ,states to adhere to minimum standards in the ,state oversight of recovery housing4 7f7 ,definitions ,in this section-- 7#a7 the term recovery housing means a shared living environment free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders2 and 7#b7 the term tribally designated housing entity has the meaning given such term in section #d of the ,native ,american ,housing ,assistance and ,self-,determination ,act of #aiif 7#be ,u4,s4,c4 #dajc74 #adaj4 ,addressing economic and workforce impacts of the opioid crisis 7a7 ,definitions ,except as otherwise expressly provided1 in this section3 7#a7 ,,wioa definitions ,the terms core program1 individual with a barrier to employment1 local area1 local board1 one-stop operator1 outlying area1 ,state1 ,state board1 and supportive services have the meanings given the terms in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7#b7 ,education provider ,the term education provider means-- 7,a7 an institution of higher education1 as defined in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja72 or 7,b7 a postsecondary vocational institution1 as defined in section #ajb7;c7 of such ,act 7#bj ,u4,s4,c4 #ajjb7;c774 7#c7 ,eligible entity ,the term eligible entity means-- 7,a7 a ,state workforce agency2 7,b7 an outlying area2 or 7,c7 a ,tribal entity4 7#d7 ,participating partnership ,the term participating partnership means a partnership-- 7,a7 evidenced by a written contract or agreement2 and 7,b7 including1 as members of the partnership1 a local board receiving a subgrant under subsection 7d7 and #a or more of the following3 7i7 ,the eligible entity4 7ii7 ,a treatment provider4 7iii7 ,an employer or industry organization4 7iv7 ,an education provider4 7v7 ,a legal service or law enforcement organization4 7vi7 ,a faith-based or community-based organization4 7vii7 ,other ,state or local agencies1 including counties or local governments4 7viii7 ,other organizations1 as determined to be necessary by the local board4 7ix7 ,indian ,tribes or tribal organizations4 7#e7 ,program participant ,the term program participant means an individual who-- 7,a7 is a member of a population of workers described in subsection 7e77#b7 that is served by a participating partnership through the pilot program under this section2 and 7,b7 enrolls with the applicable participating partnership to receive any of the services described in subsection 7e77#c74 7#f7 ,provider of peer recovery support services ,the term provider of peer recovery support services means a provider that delivers peer recovery support services through an organization described in section #edg7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b7;a774 7#g7 ,secretary ,the term ,secretary means the ,secretary of ,labor4 7#h7 ,state workforce agency ,the term ,state workforce agency means the lead ,state agency with responsibility for the administration of a program under chapter #b or #c of subtitle ,b of title ,i of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cafa et seq41 #caga et seq474 7#i7 ,substance use disorder ,the term substance use disorder has the meaning given such term by the ,assistant ,secretary for ,mental ,health and ,substance ,use4 7#aj7 ,treatment provider ,the term treatment provider-- 7,a7 means a health care provider that-- 7i7 offers services for treating substance use disorders and is licensed in accordance with applicable ,state law to provide such services2 and 7ii7 accepts health insurance for such services1 including coverage under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 and 7,b7 may include-- 7i7 a nonprofit provider of peer recovery support services2 7ii7 a community health care provider2 7iii7 a ,federally qualified health center 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex772 7iv7 an ,indian health program 7as defined in section #c of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc771 including an ,indian health program that serves an urban center 7as defined in such section72 and 7v7 a ,native ,hawaiian health center 7as defined in section #ab of the ,native ,hawaiian ,health ,care ,improvement ,act 7#db ,u4,s4,c4 #aagaa774 7#aa7 ,tribal entity ,the term ,tribal entity includes any ,indian ,tribe1 tribal organization1 ,indian-controlled organization serving ,indians1 ,native ,hawaiian organization1 or ,alaska ,native entity1 as such terms are defined or used in section #aff of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cbba74 7b7 ,pilot program and grants authorized 7#a7 ,in general ,the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 shall carry out a pilot program to address economic and workforce impacts associated with a high rate of a substance use disorder4 ,in carrying out the pilot program1 the ,secretary shall make grants1 on a competitive basis1 to eligible entities to enable such entities to make subgrants to local boards to address the economic and workforce impacts associated with a high rate of a substance use disorder4 7#b7 ,grant amounts ,the ,secretary shall make each such grant in an amount that is not less than #ejj1jjj1 and not more than #e1jjj1jjj1 for a fiscal year4 7c7 ,grant applications 7#a7 ,in general ,an eligible entity applying for a grant under this section shall submit an application to the ,secretary at such time and in such form and manner as the ,secretary may reasonably require1 including the information described in this subsection4 7#b7 ,significant impact on community by opioid and substance use disorder-related problems 7,a7 ,demonstration ,an eligible entity shall include in the application-- 7i7 information that demonstrates significant impact on the community by problems related to opioid abuse or another substance use disorder1 by-- 7,i7 identifying the counties1 communities1 regions1 or local areas that have been significantly impacted and will be served through the grant 7each referred to in this section as a service area72 and 7,,ii7 demonstrating for each such service area1 an increase equal to or greater than the national increase in such problems1 between-- 7aa7 #aiii2 and 7bb7 #bjaf or the latest year for which data are available2 and 7ii7 a description of how the eligible entity will prioritize support for significantly impacted service areas described in clause 7i77,i74 7,b7 ,information ,to meet the requirements described in subparagraph 7,a77i77,,ii71 the eligible entity may use information including data on-- 7i7 the incidence or prevalence of opioid abuse and other substance use disorders2 7ii7 the age-adjusted rate of drug overdose deaths1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention2 7iii7 the rate of non-fatal hospitalizations related to opioid abuse or other substance use disorders2 7iv7 the number of arrests or convictions1 or a relevant law enforcement statistic1 that reasonably shows an increase in opioid abuse or another substance use disorder2 or 7v7 in the case of an eligible entity described in subsection 7a77#c77;,c71 other alternative relevant data as determined appropriate by the ,secretary4 7,c7 ,support for state strategy ,the eligible entity may include in the application information describing how the proposed services and activities are aligned with the ,state1 outlying area1 or ,tribal strategy1 as applicable1 for addressing problems described in subparagraph 7,a7 in specific service areas or across the ,state1 outlying area1 or ,tribal land4 7#c7 ,economic and employment conditions demonstrate additional ,federal support needed 7,a7 ,demonstration ,an eligible entity shall include in the application information that demonstrates that a high rate of a substance use disorder has caused1 or is coincident to-- 7i7 an economic or employment downturn in the service area2 or 7ii7 persistent economically depressed conditions in such service area4 7,b7 ,information ,to meet the requirements of subparagraph 7,a71 an eligible entity may use information including-- 7i7 documentation of any layoff1 announced future layoff1 legacy industry decline1 decrease in an employment or labor market participation rate1 or economic impact1 whether or not the result described in this clause is overtly related to a high rate of a substance use disorder2 7ii7 documentation showing decreased economic activity related to1 caused by1 or contributing to a high rate of a substance use disorder1 including a description of how the service area has been impacted1 or will be impacted1 by such a decrease2 7iii7 information on economic indicators1 labor market analyses1 information from public announcements1 and demographic and industry data2 7iv7 information on rapid response activities 7as defined in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb77 that have been or will be conducted1 including demographic data gathered by employer or worker surveys or through other methods2 7v7 data or documentation1 beyond anecdotal evidence1 showing that employers face challenges filling job vacancies due to a lack of skilled workers able to pass a drug test2 or 7vi7 any additional relevant data or information on the economy1 workforce1 or another aspect of the service area to support the application4 7d7 ,subgrant authorization and application process 7#a7 ,subgrants authorized 7,a7 ,in general ,an eligible entity receiving a grant under subsection 7b7-- 7i7 may use not more than #e percent of the grant funds for the administrative costs of carrying out the grant2 7ii7 in the case of an eligible entity described in subparagraph 7,a7 or 7,b7 of subsection 7a77#c71 shall use the remaining grant funds to make subgrants to local entities in the service area to carry out the services and activities described in subsection 7e72 and 7iii7 in the case of an eligible entity described in subsection 7a77#c77;,c71 shall use the remaining grant funds to carry out the services and activities described in subsection 7e74 7,b7 ,equitable distribution ,in making subgrants under this subsection1 an eligible entity shall ensure1 to the extent practicable1 the equitable distribution of subgrants1 based on-- 7i7 geography 7such as urban and rural distribution72 and 7ii7 significantly impacted service areas as described in subsection 7c77#b74 7,c7 ,timing of subgrant funds distribution ,an eligible entity making subgrants under this subsection shall disburse subgrant funds to a local board receiving a subgrant from the eligible entity by the later of-- 7i7 the date that is #ij days after the date on which the ,secretary makes the funds available to the eligible entity2 or 7ii7 the date that is #ae days after the date that the eligible entity makes the subgrant under subparagraph 7,a77ii74 7#b7 ,subgrant application 7,a7 ,in general ,a local board desiring to receive a subgrant under this subsection from an eligible entity shall submit an application at such time and in such manner as the eligible entity may reasonably require1 including the information described in this paragraph4 7,b7 ,contents ,each application described in subparagraph 7,a7 shall include-- 7i7 an analysis of the estimated performance of the local board in carrying out the proposed services and activities under the subgrant-- 7,i7 based on-- 7aa7 primary indicators of performance described in section #aaf7;c77#a77;,a77i7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cada7;c77#a77;,a77i71 to assess estimated effectiveness of the proposed services and activities1 including the estimated number of individuals with a substance use disorder who may be served by the proposed services and activities2 7bb7 the record of the local board in serving individuals with a barrier to employment2 and 7cc7 the ability of the local board to establish a participating partnership2 and 7,,ii7 which may include or utilize-- 7aa7 data from the ,national ,center for ,health ,statistics of the ,centers for ,disease ,control and ,prevention2 7bb7 data from the ,center for ,behavioral ,health ,statistics and ,quality of the ,substance ,abuse and ,mental ,health ,services ,administration2 7cc7 ,state vital statistics2 7dd7 municipal police department records2 7ee7 reports from local coroners2 or 7ff7 other relevant data2 and 7ii7 in the case of a local board proposing to serve a population described in subsection 7e77#b77;,b71 a demonstration of the workforce shortage in the professional area to be addressed under the subgrant 7which may include substance use disorder treatment and related services1 non-addictive pain therapy and pain management services1 mental health care treatment services1 emergency response services1 or mental health care71 which shall include information that can demonstrate such a shortage1 such as-- 7,i7 the distance between-- 7aa7 communities affected by opioid abuse or another substance use disorder2 and 7bb7 facilities or professionals offering services in the professional area2 or 7,,ii7 the maximum capacity of facilities or professionals to serve individuals in an affected community1 or increases in arrests related to opioid or another substance use disorder1 overdose deaths1 or nonfatal overdose emergencies in the community4 7e7 ,subgrant services and activities 7#a7 ,in general ,each local board that receives a subgrant under subsection 7d7 shall carry out the services and activities described in this subsection through a participating partnership4 7#b7 ,selection of ,population to be served ,a participating partnership shall elect to provide services and activities under the subgrant to one or both of the following populations of workers3 7,a7 ,workers1 including dislocated workers1 individuals with barriers to employment1 new entrants in the workforce1 or incumbent workers 7employed or underemployed71 each of whom-- 7i7 is directly or indirectly affected by a high rate of a substance use disorder2 and 7ii7 voluntarily confirms that the worker1 or a friend or family member of the worker1 has a history of opioid abuse or another substance use disorder4 7,b7 ,workers1 including dislocated workers1 individuals with barriers to employment1 new entrants in the workforce1 or incumbent workers 7employed or underemployed71 who-- 7i7 seek to transition to professions that support individuals with a substance use disorder or at risk for developing such disorder1 such as professions that provide-- 7,i7 substance use disorder treatment and related services2 7,,ii7 services offered through providers of peer recovery support services2 7,,iii7 non-addictive pain therapy and pain management services2 7,,iv7 emergency response services2 or 7,v7 mental health care2 and 7ii7 need new or upgraded skills to better serve such a population of struggling or at-risk individuals4 7#c7 ,services and activities ,each participating partnership shall use funds available through a subgrant under this subsection to carry out #a or more of the following3 7,a7 ,engaging employers ,engaging with employers to-- 7i7 learn about the skill and hiring requirements of employers2 7ii7 learn about the support needed by employers to hire and retain program participants1 and other individuals with a substance use disorder1 and the support needed by such employers to obtain their commitment to testing creative solutions to employing program participants and such individuals2 7iii7 connect employers and workers to on-the-job or customized training programs before or after layoff to help facilitate reemployment2 7iv7 connect employers with an education provider to develop classroom instruction to complement on-the-job learning for program participants and such individuals2 7v7 help employers develop the curriculum design of a work-based learning program for program participants and such individuals2 7vi7 help employers employ program participants or such individuals engaging in a work-based learning program for a transitional period before hiring such a program participant or individual for full-time employment of not less than #cj hours a week2 or 7vii7 connect employers to program participants receiving concurrent outpatient treatment and job training services4 7,b7 ,screening services ,providing screening services1 which may include-- 7i7 using an evidence-based screening method to screen each individual seeking participation in the pilot program to determine whether the individual has a substance use disorder2 7ii7 conducting an assessment of each such individual to determine the services needed for such individual to obtain or retain employment1 including an assessment of strengths and general work readiness2 or 7iii7 accepting walk-ins or referrals from employers1 labor organizations1 or other entities recommending individuals to participate in such program4 7,c7 ,individual treatment and employment plan ,developing an individual treatment and employment plan for each program participant-- 7i7 in coordination1 as appropriate1 with other programs serving the participant such as the core programs within the workforce development system under the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #caja et seq472 and 7ii7 which shall include providing a case manager to work with each participant to develop the plan1 which may include-- 7,i7 identifying employment and career goals2 7,,ii7 exploring career pathways that lead to in-demand industries and sectors1 as determined by the ,state board and the head of the ,state workforce agency or1 as applicable1 the ,tribal entity2 7,,iii7 setting appropriate achievement objectives to attain the employment and career goals identified under subclause 7,i72 or 7,,iv7 developing the appropriate combination of services to enable the participant to achieve the employment and career goals identified under subclause 7,i74 7,d7 ,outpatient treatment and recovery care ,in the case of a participating partnership serving program participants described in paragraph 7#b77;,a7 with a substance use disorder1 providing individualized and group outpatient treatment and recovery services for such program participants that are offered during the day and evening1 and on weekends4 ,such treatment and recovery services-- 7i7 shall be based on a model that utilizes combined behavioral interventions and other evidence-based or evidence-informed interventions2 and 7ii7 may include additional services such as-- 7,i7 health1 mental health1 addiction1 or other forms of outpatient treatment that may impact a substance use disorder and co-occurring conditions2 7,,ii7 drug testing for a current substance use disorder prior to enrollment in career or training services or prior to employment2 7,,iii7 linkages to community services1 including services offered by partner organizations designed to support program participants2 or 7,,iv7 referrals to health care1 including referrals to substance use disorder treatment and mental health services4 7,e7 ,supportive services ,providing supportive services1 which shall include services such as-- 7i7 coordinated wraparound services to provide maximum support for program participants to assist the program participants in maintaining employment and recovery for not less than #ab months1 as appropriate2 7ii7 assistance in establishing eligibility for assistance under ,federal1 ,state1 ,tribal1 and local programs providing health services1 mental health services1 vocational services1 housing services1 transportation services1 social services1 or services through early childhood education programs 7as defined in section #ajc of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajjc772 7iii7 services offered through providers of peer recovery support services2 7iv7 networking and mentorship opportunities2 or 7v7 any supportive services determined necessary by the local board4 7,f7 ,career and job training services ,offering career services and training services1 and related services1 concurrently or sequentially with the services provided under subparagraphs 7,b7 through 7,e74 ,such services shall include the following3 7i7 ,services provided to program participants who are in a pre-employment stage of the program1 which may include-- 7,i7 initial education and skills assessments2 7,,ii7 traditional classroom training funded through individual training accounts under chapter #c of subtitle ,b of title ,i of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #caga et seq472 7,,iii7 services to promote employability skills such as punctuality1 personal maintenance skills1 and professional conduct2 7,,iv7 in-depth interviewing and evaluation to identify employment barriers and to develop individual employment plans2 7,v7 career planning that includes-- 7aa7 career pathways leading to in-demand1 high-wage jobs2 and 7bb7 job coaching1 job matching1 and job placement services2 7,,vi7 provision of payments and fees for employment and training-related applications1 tests1 and certifications2 or 7,,vii7 any other appropriate career service or training service described in section #acd7;c7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cagd7;c774 7ii7 ,services provided to program participants during their first #f months of employment to ensure job retention1 which may include-- 7,i7 case management and support services1 including a continuation of the services described in clause 7i72 7,,ii7 a continuation of skills training1 and career and technical education1 described in clause 7i7 that is conducted in collaboration with the employers of such participants2 7,,iii7 mentorship services and job retention support for such participants2 or 7,,iv7 targeted training for managers and workers working with such participants 7such as mentors71 and human resource representatives in the business in which such participants are employed4 7iii7 ,services to assist program participants in maintaining employment for not less than #ab months1 as appropriate4 7,g7 ,proven and promising practices ,leading efforts in the service area to identify and promote proven and promising strategies and initiatives for meeting the needs of employers and program participants4 7#d7 ,limitations ,a participating partnership may not use-- 7,a7 more than #aj percent of the funds received under a subgrant under subsection 7d7 for the administrative costs of the partnership2 7,b7 more than #aj percent of the funds received under such subgrant for the provision of treatment and recovery services1 as described in paragraph 7#c77;,d72 and 7,c7 more than #aj percent of the funds received under such subgrant for the provision of supportive services described in paragraph 7#c77;,e7 to program participants4 7f7 ,performance accountability 7#a7 ,reports ,the ,secretary shall establish quarterly reporting requirements for recipients of grants and subgrants under this section that1 to the extent practicable1 are based on the performance accountability system under section #aaf of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cada7 and1 in the case of a grant awarded to an eligible entity described in subsection 7a77#c77;,c71 section #aff7;h7 of such ,act 7#bi ,u4,s4,c4 #cbba7;h771 including the indicators described in subsection 7c77#a77;,a77i7 of such section #aaf and the requirements for local area performance reports under subsection 7d7 of such section #aaf4 7#b7 ,evaluations 7,a7 ,authority to enter into agreements ,the ,secretary shall ensure that an independent evaluation is conducted on the pilot program carried out under this section to determine the impact of the program on employment of individuals with substance use disorders4 ,the ,secretary shall enter into an agreement with eligible entities receiving grants under this section to pay for all or part of such evaluation4 7,b7 ,methodologies to be used ,the independent evaluation required under this paragraph shall use experimental designs using random assignment or1 when random assignment is not feasible1 other reliable1 evidence-based research methodologies that allow for the strongest possible causal inferences4 7g7 ,funding 7#a7 ,covered fiscal year ,in this subsection1 the term covered fiscal year means any of fiscal years #bjah through #bjbc4 7#b7 ,using funding for national dislocated worker grants ,subject to paragraph 7#d7 and notwithstanding section #acb7;a77#b77;,a7 and subtitle ,d of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cagb7;a77#b77;,a71 #cbba et seq471 the ,secretary may use1 to carry out the pilot program under this section for a covered fiscal year-- 7,a7 funds made available to carry out section #agj of such ,act 7#bi ,u4,s4,c4 #cbbe7 for that fiscal year2 7,b7 funds made available to carry out section #agj of such ,act that remain available for that fiscal year2 and 7,c7 funds that remain available under section #agb7;f7 of such ,act 7#bi ,u4,s4,c4 #cbbg7;f774 7#c7 ,availability of funds ,funds appropriated under section #acf7;c7 of such ,act 7#bi ,u4,s4,c4 #caha7;c77 and made available to carry out section #agj of such ,act for a fiscal year shall remain available for use under paragraph 7#b7 for a subsequent fiscal year until expended4 7#d7 ,limitation ,the ,secretary may not use more than #ajj1jjj1jjj of the funds described in paragraph 7#b7 for any covered fiscal year under this section4 #adaa4 ,career ,act 7a7 ,in general ,the ,secretary1 in consultation with the ,secretary of ,labor1 shall continue or establish a program to support individuals in recovery from a substance use disorder transition to independent living and the workforce4 7b7 ,grants authorized ,in carrying out the activities under this section1 the ,secretary shall1 on a competitive basis1 award grants for a period of not more than #e years to entities to enable such entities to carry out evidence-based programs to help individuals in recovery from a substance use disorder transition from treatment to independent living and the workforce4 ,such entities shall coordinate1 as applicable1 with ,indian tribes or tribal organizations 7as applicable71 ,state boards and local boards 7as defined in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb71 lead ,state agencies with responsibility for a workforce investment activity 7as defined in such section #c71 and ,state agencies responsible for carrying out substance use disorder prevention and treatment programs4 7c7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to entities located in a ,state with-- 7#a7 an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention2 7#b7 a rate of unemployment1 based on data provided by the ,bureau of ,labor ,statistics for calendar years #bjac through #bjag1 that is above the national average2 and 7#c7 a rate of labor force participation1 based on data provided by the ,bureau of ,labor ,statistics for calendar years #bjac through #bjag1 that is below the national average4 7d7 ,preference ,in awarding grants under this section1 the ,secretary shall1 as appropriate1 give preference to entities located in an area with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate4 7e7 ,applications ,an eligible entity shall submit an application at such time and in such manner as the ,secretary may require4 ,in submitting an application1 the entity shall demonstrate the ability to partner with local stakeholders1 which may include local employers1 community stakeholders1 the local workforce development board1 and local and ,state governments1 to-- 7#a7 identify gaps in the workforce due to the prevalence of substance use disorders2 7#b7 in coordination with statewide employment and training activities1 including coordination and alignment of activities carried out by entities provided grant funds under section #adaj1 help individuals in recovery from a substance use disorder transition into the workforce1 including by providing career services1 training services as described in paragraph 7#b7 of section #acd7;c7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cagd7;c771 and related services described in section #acd7;a77#c7 of such ,act 7#db ,u4,s4,c4 #cagd7;a772 and 7#c7 assist employers with informing their employees of the resources1 such as resources related to substance use disorders that are available to their employees4 7f7 ,use of funds ,an entity receiving a grant under this section shall use the funds to conduct one or more of the following activities3 7#a7 ,hire case managers1 care coordinators1 providers of peer recovery support services1 as described in section #edg7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b7;a771 or other professionals1 as appropriate1 to provide services that support treatment1 recovery1 and rehabilitation1 and prevent relapse1 recidivism1 and overdose1 including by encouraging-- 7,a7 the development of daily living skills2 and 7,b7 the use of counseling1 care coordination1 and other services1 as appropriate1 to support recovery from substance use disorders4 7#b7 ,implement or utilize innovative technologies1 which may include the use of telemedicine4 7#c7 ,in coordination with the lead ,state agency with responsibility for a workforce investment activity or local board described in subsection 7b71 provide-- 7,a7 short-term prevocational training services2 and 7,b7 training services that are directly linked to the employment opportunities in the local area or the planning region4 7g7 ,support for ,state strategy ,an eligible entity shall include in its application under subsection 7e7 information describing how the services and activities proposed in such application are aligned with the ,state1 outlying area1 or ,tribal strategy1 as applicable1 for addressing issues described in such application and how such entity will coordinate with existing systems to deliver services as described in such application4 7h7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary for each of fiscal years #bjai through #bjbc for purposes of carrying out this section4 #adab4 ,pilot program to help individuals in recovery from a substance use disorder become stably housed 7a7 ,authorization of appropriations ,there is authorized to be appropriated under this section such sums as may be necessary for each of fiscal years #bjai through #bjbc for assistance to ,states to provide individuals in recovery from a substance use disorder stable1 temporary housing for a period of not more than #b years or until the individual secures permanent housing1 whichever is earlier4 7b7 ,allocation of appropriated amounts 7#a7 ,in general ,the amounts appropriated or otherwise made available to ,states under this section shall be allocated based on a funding formula established by the ,secretary of ,housing and ,urban ,development 7referred to in this section as the ,secretary7 not later than #fj days after the date of enactment of this ,act4 7#b7 ,criteria ,the funding formula required under paragraph 7#a7 shall ensure that any amounts appropriated or otherwise made available under this section are allocated to ,states with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate1 according to the ,centers for ,disease ,control and ,prevention4 ,among such ,states1 priority shall be given to ,states with the greatest need1 as such need is determined by the ,secretary based on-- 7,a7 the highest average rates of unemployment based on data provided by the ,bureau of ,labor ,statistics for calendar years #bjac through #bjag2 7,b7 the lowest average labor force participation rates based on data provided by the ,bureau of ,labor ,statistics for calendar years #bjac through #bjag2 and 7,c7 the highest prevalence of opioid use disorder based on data provided by the ,substance ,abuse and ,mental ,health ,services ,administration for calendar years #bjac through #bjag4 7#c7 ,distribution ,amounts appropriated or otherwise made available under this section shall be distributed according to the funding formula established by the ,secretary under paragraph 7#a7 not later than #cj days after the establishment of such formula4 7c7 ,use of funds 7#a7 ,in general ,any ,state that receives amounts pursuant to this section shall expend at least #cj percent of such funds within one year of the date funds become available to the grantee for obligation4 7#b7 ,priority ,any ,state that receives amounts pursuant to this section shall distribute such amounts giving priority to entities with the greatest need and ability to deliver effective assistance in a timely manner4 7#c7 ,administrative costs ,any ,state that receives amounts pursuant to this section may use up to #e percent of any grant for administrative costs4 7d7 ,rules of construction 7#a7 ,in general ,except as otherwise provided by this section1 amounts appropriated1 or amounts otherwise made available to ,states under this section shall be treated as though such funds were community development block grant funds under title ,i of the ,housing and ,community ,development ,act of #aigd 7#db ,u4,s4,c4 #ecja et seq474 7#b7 ,no match ,no matching funds shall be required in order for a ,state to receive any amounts under this section4 7e7 ,authority to waive or specify alternative requirements 7#a7 ,in general ,in administering any amounts appropriated or otherwise made available under this section1 the ,secretary may waive or specify alternative requirements for any provision of any statute or regulation in connection with the obligation by the ,secretary or the use of funds except for requirements related to fair housing1 nondiscrimination1 labor standards1 and the environment1 upon a finding that such a waiver is necessary to expedite or facilitate the use of such funds4 7#b7 ,notice ,the ,secretary shall provide written notice of its intent to exercise the authority to specify alternative requirements under paragraph 7#a7 to the ,committee on ,banking1 ,housing1 and ,urban ,affairs of the ,senate and the ,committee on ,financial ,services of the ,house of ,representatives not later than #e business days before such exercise of authority occurs4 7f7 ,technical assistance ,for the #b-year period following the date of enactment of this ,act1 the ,secretary may use not more than #b percent of the funds made available under this section for technical assistance to grantees4 7g7 ,state ,for purposes of this section the term ,state includes any ,state as defined in section #ajb of the ,housing and ,community ,development ,act of #aigd 7#db ,u4,s4,c4 #ecjb7 and the ,district of ,columbia4 #adac4 ,youth prevention and recovery 7a7 ,substance abuse treatment services for children1 adolescents1 and young adults ,section #ead of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#g7 is amended-- 7#a7 in the section heading1 by striking children and adolescents and inserting children1 adolescents1 and young adults2 7#b7 in subsection 7a77#b71 by striking children1 including and inserting children1 adolescents1 and young adults1 including2 and 7#c7 by striking children and adolescents each place it appears and inserting children1 adolescents1 and young adults4 7b7 ,resource center ,the ,secretary1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,use and1 as appropriate1 in consultation with the ,secretary of ,education and other agencies1 shall establish a resource center to provide technical support to recipients of grants under subsection 7c74 7c7 ,youth prevention and recovery initiative 7#a7 ,in general ,the ,secretary1 in consultation with the ,secretary of ,education1 shall administer a program to provide support for communities to support the prevention of1 treatment of1 and recovery from1 substance use disorders for children1 adolescents1 and young adults4 7#b7 ,definitions ,in this subsection3 7,a7 ,eligible entity ,the term eligible entity means-- 7i7 a local educational agency that is seeking to establish or expand substance use prevention or recovery support services at one or more high schools2 7ii7 a ,state educational agency2 7iii7 an institution of higher education 7or consortia of such institutions71 which may include a recovery program at an institution of higher education2 7iv7 a local board or one-stop operator2 7v7 a nonprofit organization with appropriate expertise in providing services or programs for children1 adolescents1 or young adults1 excluding a school2 7vi7 a ,state1 political subdivision of a ,state1 ,indian ,tribe1 or tribal organization2 or 7vii7 a high school or dormitory serving high school students that receives funding from the ,bureau of ,indian ,education4 7,b7 ,evidence-based ,the term evidence-based has the meaning given such term in section #haja of the ,elementary and ,secondary ,education ,act 7#bj ,u4,s4,c4 #ghja74 7,c7 ,foster care ,the term foster care has the meaning given such term in section #acee4bj7;a7 of title #de1 ,code of ,federal ,regulations 7or any successor regulations74 7,d7 ,high school ,the term high school has the meaning given such term in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7,e7 ,homeless youth ,the term homeless youth has the meaning given the term homeless children or youths in section #gbe of the ,mc,kinney-,vento ,homeless ,assistance ,act 7#db ,u4,s4,c4 #aadcd;a72 7,f7 ,institution of higher education ,the term institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja7 and includes a postsecondary vocational institution as defined in section #ajb7;c7 of such ,act 7#bj ,u4,s4,c4 #ajjb7;c774 7,g7 ,local educational agency ,the term local educational agency has the meaning given the term in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7,h7 ,local board2 one-stop operator ,the terms local board and one-stop operator have the meanings given such terms in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7,i7 ,out of ,school ,youth ,the term out-of-school youth has the meaning given such term in section #abi7;a77#a77;,b7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cafd7;a77#a77;,b774 7,j7 ,recovery program ,the term recovery program means a program-- 7i7 to help children1 adolescents1 or young adults who are recovering from substance use disorders to initiate1 stabilize1 and maintain healthy and productive lives in the community2 and 7ii7 that includes peer-to-peer support delivered by individuals with lived experience in recovery1 and communal activities to build recovery skills and supportive social networks4 7,k7 ,state ,educational ,agency ,the term ,state educational agency has the meaning given the term in section #haja of the ,elementary and ,secondary ,education ,act 7#bj ,u4,s4,c4 #ghja74 7#c7 ,best practices ,the ,secretary1 in consultation with the ,secretary of ,education1 shall-- 7,a7 identify or facilitate the development of evidence-based best practices for prevention of substance misuse and abuse by children1 adolescents1 and young adults1 including for specific populations such as youth in foster care1 homeless youth1 out-of-school youth1 and youth who are at risk of or have experienced trafficking that address-- 7i7 primary prevention2 7ii7 appropriate recovery support services2 7iii7 appropriate use of medication-assisted treatment for such individuals1 if applicable1 and ways of overcoming barriers to the use of medication-assisted treatment in such population2 and 7iv7 efficient and effective communication1 which may include the use of social media1 to maximize outreach efforts2 7,b7 disseminate such best practices to ,state educational agencies1 local educational agencies1 schools and dormitories funded by the ,bureau of ,indian ,education1 institutions of higher education1 recovery programs at institutions of higher education1 local boards1 one-stop operators1 family and youth homeless providers1 and nonprofit organizations1 as appropriate2 7,c7 conduct a rigorous evaluation of each grant funded under this subsection1 particularly its impact on the indicators described in paragraph 7#h77;,b72 and 7,d7 provide technical assistance for grantees under this subsection4 7#d7 ,grants authorized ,the ,secretary1 in consultation with the ,secretary of ,education1 shall award #c-year grants1 on a competitive basis1 to eligible entities to enable such entities1 in coordination with ,indian ,tribes1 if applicable1 and ,state agencies responsible for carrying out substance use disorder prevention and treatment programs1 to carry out evidence-based programs for-- 7,a7 prevention of substance misuse and abuse by children1 adolescents1 and young adults1 which may include primary prevention2 7,b7 recovery support services for children1 adolescents1 and young adults1 which may include counseling1 job training1 linkages to community-based services1 family support groups1 peer mentoring1 and recovery coaching2 or 7,c7 treatment or referrals for treatment of substance use disorders1 which may include the use of medication-assisted treatment1 as appropriate4 7#e7 ,special consideration ,in awarding grants under this subsection1 the ,secretary shall give special consideration to the unique needs of tribal1 urban1 suburban1 and rural populations4 7#f7 ,application ,to be eligible for a grant under this subsection1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 ,such application shall include-- 7,a7 a description of-- 7i7 the impact of substance use disorders in the population that will be served by the grant program2 7ii7 how the eligible entity has solicited input from relevant stakeholders1 which may include faculty1 teachers1 staff1 families1 students1 and experts in substance use prevention and treatment in developing such application2 7iii7 the goals of the proposed project1 including the intended outcomes2 7iv7 how the eligible entity plans to use grant funds for evidence-based activities1 in accordance with this subsection to prevent1 provide recovery support for1 or treat substance use disorders amongst such individuals1 or a combination of such activities2 and 7v7 how the eligible entity will collaborate with relevant partners1 which may include ,state educational agencies1 local educational agencies1 institutions of higher education1 juvenile justice agencies1 prevention and recovery support providers1 local service providers1 including substance use disorder treatment programs1 providers of mental health services1 youth serving organizations1 family and youth homeless providers1 child welfare agencies1 and primary care providers1 in carrying out the grant program2 and 7,b7 an assurance that the eligible entity will participate in the evaluation described in paragraph 7#c77;,c74 7#g7 ,priority ,in awarding grants under this subsection1 the ,secretary shall give priority to eligible entities that propose to use grant funds for activities that meet the criteria described in subclauses 7,i7 and 7,,ii7 of section #haja7ba77;,a77i7 of the ,elementary and ,secondary ,education ,act 7#bj ,u4,s4,c4 #ghja7ba77;,a77i774 7#h7 ,reports to the ,secretary ,each eligible entity awarded a grant under this subsection shall submit to the ,secretary a report at such time and in such manner as the ,secretary may require4 ,such report shall include-- 7,a7 a description of how the eligible entity used grant funds1 in accordance with this subsection1 including the number of children1 adolescents1 and young adults reached through programming2 and 7,b7 a description1 including relevant data1 of how the grant program has made an impact on the intended outcomes described in paragraph 7#f77;,a77iii71 including-- 7i7 indicators of student success1 which1 if the eligible entity is an educational institution1 shall include student well-being and academic achievement2 7ii7 substance use disorders amongst children1 adolescents1 and young adults1 including the number of overdoses and deaths amongst children1 adolescents1 and young adults during the grant period2 and 7iii7 other indicators1 as the ,secretary determines appropriate4 7#i7 ,report to ,congress ,the ,secretary shall1 not later than ,october #a1 #bjbb1 submit a report to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and the ,committee on ,energy and ,commerce and the ,committee on ,education and the ,workforce of the ,house of ,representatives1 a report summarizing the effectiveness of the grant program under this subsection1 based on the information submitted in reports required under paragraph 7#h74 7#aj7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection for each of fiscal years #bjai through #bjbc4 #adad4 ,plans of safe care ,section #aje7;a7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf7;a77 is amended by adding at the end the following3 7#g7 ,grants to ,states to improve and coordinate their response to ensure the safety1 permanency1 and well-being of infants affected by substance use 7,a7 ,program authorized ,the ,secretary shall make grants to ,states for the purpose of assisting child welfare agencies1 social services agencies1 substance use disorder treatment agencies1 hospitals with labor and delivery units1 medical staff1 public health and mental health agencies1 and maternal and child health agencies to facilitate collaboration in developing1 updating1 implementing1 and monitoring plans of safe care described in section #ajf7;b77#b77;,b77iii74 7,b7 ,distribution of funds 7i7 ,reservations ,of the amounts appropriated under subparagraph 7,h71 the ,secretary shall reserve-- 7,i7 no more than #c percent for the purposes described in subparagraph 7,g72 and 7,,ii7 up to #c percent for grants to ,indian ,tribes and tribal organizations to address the needs of infants born with1 and identified as being affected by1 substance abuse or withdrawal symptoms resulting from prenatal drug exposure or a fetal alcohol spectrum disorder and their families or caregivers1 which to the extent practicable1 shall be consistent with the uses of funds described under subparagraph 7,d74 7ii7 ,allotments to ,states and territories ,the ,secretary shall allot the amount appropriated under subparagraph 7,h7 that remains after application of clause 7i7 to each ,state that applies for such a grant1 in an amount equal to the sum of-- 7,i7 #ejj1jjj2 and 7,,ii7 an amount that bears the same relationship to any funds appropriated under subparagraph 7,h7 and remaining after application of clause 7i71 as the number of live births in the ,state in the previous calendar year bears to the number of live births in all ,states in such year4 7iii7 ,ratable reduction ,if the amount appropriated under subparagraph 7,h7 is insufficient to satisfy the requirements of clause 7ii71 the ,secretary shall ratably reduce each allotment to a ,state4 7,c7 ,application ,a ,state desiring a grant under this paragraph shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 ,such application shall include-- 7i7 a description of-- 7,i7 the impact of substance use disorder in such ,state1 including with respect to the substance or class of substances with the highest incidence of abuse in the previous year in such ,state1 including-- 7aa7 the prevalence of substance use disorder in such ,state2 7bb7 the aggregate rate of births in the ,state of infants affected by substance abuse or withdrawal symptoms or a fetal alcohol spectrum disorder 7as determined by hospitals1 insurance claims1 claims submitted to the ,state ,medicaid program1 or other records71 if available and to the extent practicable2 and 7cc7 the number of infants identified1 for whom a plan of safe care was developed1 and for whom a referral was made for appropriate services1 as reported under section #ajf7;d77#ah72 7,,ii7 the challenges the ,state faces in developing1 implementing1 and monitoring plans of safe care in accordance with section #ajf7;b77#b77;,b77iii72 7,,iii7 the ,state's lead agency for the grant program and how that agency will coordinate with relevant ,state entities and programs1 including the child welfare agency1 the substance use disorder treatment agency1 hospitals with labor and delivery units1 health care providers1 the public health and mental health agencies1 programs funded by the ,substance ,abuse and ,mental ,health ,services ,administration that provide substance use disorder treatment for women1 the ,state ,medicaid program1 the ,state agency administering the block grant program under title ,v of the ,social ,security ,act 7#db ,u4,s4,c4 #gja et seq471 the ,state agency administering the programs funded under part ,c of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adca et seq471 the maternal1 infant1 and early childhood home visiting program under section #eaa of the ,social ,security ,act 7#db ,u4,s4,c4 #gaa71 the ,state judicial system1 and other agencies1 as determined by the ,secretary1 and ,indian ,tribes and tribal organizations1 as appropriate2 7,,iv7 how the ,state will monitor local development and implementation of plans of safe care1 in accordance with section #ajf7;b77#b77;,b77iii77,,ii71 including how the ,state will monitor to ensure plans of safe care address differences between substance use disorder and medically supervised substance use1 including for the treatment of a substance use disorder2 7,v7 how the ,state meets the requirements of section #aibg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#bg72 7,,vi7 how the ,state plans to utilize funding authorized under part ,e of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fgj et seq47 to assist in carrying out any plan of safe care1 including such funding authorized under section #dga7;e7 of such ,act 7as in effect on ,october #a1 #bjah7 for mental health and substance abuse prevention and treatment services and in-home parent skill-based programs and funding authorized under such section #dgb7;j7 7as in effect on ,october #a1 #bjah7 for children with a parent in a licensed residential family-based treatment facility for substance abuse2 and 7,,vii7 an assessment of the treatment and other services and programs available in the ,state1 to effectively carry out any plan of safe care developed1 including identification of needed treatment1 and other services and programs to ensure the well-being of young children and their families affected by substance use disorder1 such as programs carried out under part ,c of the ,individuals with ,disabilities ,education ,act and comprehensive early childhood development services and programs such as ,head ,start programs2 7ii7 a description of how the ,state plans to use funds for activities described in subparagraph 7,d7 for the purposes of ensuring ,state compliance with requirements under clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b72 and 7iii7 an assurance that the ,state will-- 7,i7 comply with this ,act and parts ,b and ,e of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fba et seq41 #fgj et seq472 and 7,,ii7 comply with requirements to refer a child identified as substance-exposed to early intervention services as required pursuant to a grant under part ,c of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adca et seq474 7,d7 ,uses of funds ,funds awarded to a ,state under this paragraph may be used for the following activities1 which may be carried out by the ,state directly1 or through grants or subgrants1 contracts1 or cooperative agreements3 7i7 ,improving ,state and local systems with respect to the development and implementation of plans of safe care1 which-- 7,i7 shall include parent and caregiver engagement1 as required under section #ajf7;b77#b77;,b77iii77,i71 regarding available treatment and service options1 which may include resources available for pregnant1 perinatal1 and postnatal women2 and 7,,ii7 may include activities such as-- 7aa7 developing policies1 procedures1 or protocols for the administration or development of evidence-based and validated screening tools for infants who may be affected by substance use withdrawal symptoms or a fetal alcohol spectrum disorder and pregnant1 perinatal1 and postnatal women whose infants may be affected by substance use withdrawal symptoms or a fetal alcohol spectrum disorder2 7bb7 improving assessments used to determine the needs of the infant and family2 7cc7 improving ongoing case management services2 and 7dd7 improving access to treatment services1 which may be prior to the pregnant woman's delivery date4 7ii7 ,developing policies1 procedures1 or protocols in consultation and coordination with health professionals1 public and private health facilities1 and substance use disorder treatment agencies to ensure that-- 7,i7 appropriate notification to child protective services is made in a timely manner2 7,,ii7 a plan of safe care is in place1 in accordance with section #ajf7;b77#b77;,b77iii71 before the infant is discharged from the birth or health care facility2 and 7,,iii7 such health and related agency professionals are trained on how to follow such protocols and are aware of the supports that may be provided under a plan of safe care4 7iii7 ,training health professionals and health system leaders1 child welfare workers1 substance use disorder treatment agencies1 and other related professionals such as home visiting agency staff and law enforcement in relevant topics including-- 7,i7 ,state mandatory reporting laws and the referral and process requirements for notification to child protective services when child abuse or neglect reporting is not mandated2 7,,ii7 the co-occurrence of pregnancy and substance use disorder1 and implications of prenatal exposure2 7,,iii7 the clinical guidance about treating substance use disorder in pregnant and postpartum women2 7,,iv7 appropriate screening and interventions for infants affected by substance use disorder1 withdrawal symptoms1 or a fetal alcohol spectrum disorder and the requirements under section #ajf7;b77#b77;,b77iii72 and 7,v7 appropriate multigenerational strategies to address the mental health needs of the parent and child together4 7iv7 ,establishing partnerships1 agreements1 or memoranda of understanding between the lead agency and health professionals1 health facilities1 child welfare professionals1 juvenile and family court judges1 substance use and mental disorder treatment programs1 early childhood education programs1 and maternal and child health and early intervention professionals1 including home visiting providers1 peer-to-peer recovery programs such as parent mentoring programs1 and housing agencies to facilitate the implementation of1 and compliance with section #ajf7;b77#b7 and clause 7ii7 of this subparagraph1 in areas which may include-- 7,i7 developing a comprehensive1 multi-disciplinary assessment and intervention process for infants1 pregnant women1 and their families who are affected by substance use disorder1 withdrawal symptoms1 or a fetal alcohol spectrum disorder1 that includes meaningful engagement with and takes into account the unique needs of each family and addresses differences between medically supervised substance use1 including for the treatment of substance use disorder1 and substance use disorder2 7,,ii7 ensuring that treatment approaches for serving infants1 pregnant women1 and perinatal and postnatal women whose infants may be affected by substance use1 withdrawal symptoms1 or a fetal alcohol spectrum disorder1 are designed to1 where appropriate1 keep infants with their mothers during both inpatient and outpatient treatment2 and 7,,iii7 increasing access to all evidence-based medication-assisted treatment approved by the ,food and ,drug ,administration1 behavioral therapy1 and counseling services for the treatment of substance use disorders1 as appropriate4 7v7 ,developing and updating systems of technology for improved data collection and monitoring under section #ajf7;b77#b77;,b77iii71 including existing electronic medical records1 to measure the outcomes achieved through the plans of safe care1 including monitoring systems to meet the requirements of this ,act and submission of performance measures4 7,e7 ,reporting ,each ,state that receives funds under this paragraph1 for each year such funds are received1 shall submit a report to the ,secretary1 disaggregated by geographic location1 economic status1 and major racial and ethnic groups1 except that such disaggregation shall not be required if the results would reveal personally identifiable information on1 with respect to infants identified under section #ajf7;b77#b77;,b77ii7-- 7i7 the number who experienced removal associated with parental substance use2 7ii7 the number who experienced removal and subsequently are reunified with parents1 and the length of time between such removal and reunification2 7iii7 the number who are referred to community providers without a child protection case2 7iv7 the number who receive services while in the care of their birth parents2 7v7 the number who receive post-reunification services within #a year after a reunification has occurred2 and 7vi7 the number who experienced a return to out-of-home care within #a year after reunification4 7,f7 ,secretary's report to congress ,the ,secretary shall submit an annual report to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,education and the ,workforce and the ,committee on ,appropriations of the ,house of ,representatives that includes the information described in subparagraph 7,e7 and recommendations or observations on the challenges1 successes1 and lessons derived from implementation of the grant program4 7,g7 ,reservation of funds ,the ,secretary shall use the amount reserved under subparagraph 7,b77i77,i7 for the purposes of-- 7i7 providing technical assistance1 including programs of in-depth technical assistance1 to additional ,states1 territories1 and ,indian ,tribes and tribal organizations in accordance with the substance-exposed infant initiative developed by the ,national ,center on ,substance ,abuse and ,child ,welfare2 7ii7 issuing guidance on the requirements of this ,act with respect to infants born with and identified as being affected by substance use or withdrawal symptoms or fetal alcohol spectrum disorder1 as described in clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b71 including by-- 7,i7 clarifying key terms2 and 7,,ii7 disseminating best practices on implementation of plans of safe care1 on such topics as differential response1 collaboration and coordination1 and identification and delivery of services for different populations2 7iii7 supporting ,state efforts to develop information technology systems to manage plans of safe care2 and 7iv7 preparing the ,secretary's report to ,congress described in subparagraph 7,f74 7,h7 ,authorization of appropriations ,to carry out the program under this paragraph1 there is authorized to be appropriated #fj1jjj1jjj for each of fiscal years #bjai through #bjbc4 4 #adae4 ,regulations relating to special registration for telemedicine ,section #caa7;h7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hca7;h77 is amended by striking paragraph 7#b7 and inserting the following3 7#b7 ,regulations 7,a7 ,in general ,not later than #a year after the date of enactment of the ,opioid ,crisis ,response ,act of #bjah1 in consultation with the ,secretary1 and in accordance with the procedure described in subparagraph 7,b71 the ,attorney ,general shall promulgate final regulations specifying-- 7i7 the limited circumstances in which a special registration under this subsection may be issued2 and 7ii7 the procedure for obtaining a special registration under this subsection4 7,b7 ,procedure ,in promulgating final regulations under subparagraph 7,a71 the ,attorney ,general shall-- 7i7 issue a notice of proposed rulemaking that includes a copy of the proposed regulations2 7ii7 provide a period of not less than #fj days for comments on the proposed regulations2 7iii7 finalize the proposed regulation not later than #f months after the close of the comment period2 and 7iv7 publish the final regulations not later than #cj days before the effective date of the final regulations4 4 #adaf4 ,national ,health ,service ,corps behavioral and mental health professionals providing obligated service in schools and other community-based settings ,subpart ,,iii of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl et seq47 is amended by adding at the end the following3 #cch,n4 ,behavioral and mental health professionals providing obligated service in schools and other community-based settings 7a7 ,schools and community-based settings ,an entity to which a participant in the ,scholarship ,program or the ,loan ,repayment ,program 7referred to in this section as a participant7 is assigned under section #ccc may direct such participant to provide service as a behavioral or mental health professional at a school or other community-based setting located in a health professional shortage area4 7b7 ,obligated service 7#a7 ,in general ,any service described in subsection 7a7 that a participant provides may count towards such participant's completion of any obligated service requirements under the ,scholarship ,program or the ,loan ,repayment ,program1 subject to any limitation imposed under paragraph 7#b74 7#b7 ,limitation ,the ,secretary may impose a limitation on the number of hours of service described in subsection 7a7 that a participant may credit towards completing obligated service requirements1 provided that the limitation allows a member to credit service described in subsection 7a7 for not less than #ej percent of the total hours required to complete such obligated service requirements4 7c7 ,rule of construction ,the authorization under subsection 7a7 shall be notwithstanding any other provision of this subpart or subpart ,,ii4 4 #adag4 ,loan repayment for substance use disorder treatment providers 7a7 ,loan repayment for substance use treatment providers ,the ,secretary shall enter into contracts under section #cch;,b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl-#a7 with eligible health professionals providing substance use disorder treatment services in substance use disorder treatment facilities1 as defined by the ,secretary4 7b7 ,provision of substance use disorder treatment ,in carrying out the activities described in subsection 7a7-- 7#a7 each such facility shall be located in or serving a mental health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e71 or1 as the ,secretary determines appropriate1 an area with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate2 7#b7 section #cca7;a77#c77;,d7 of such ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,d77 shall be applied as if the term primary health services includes health services regarding substance use disorder treatment and infections associated with illicit drug use2 7#c7 section #cca7;a77#c77;,e77i7 of such ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,e77i77 shall be applied as if the term behavioral and mental health professionals includes master's level1 licensed substance use disorder treatment counselors1 and other relevant professionals or paraprofessionals1 as the ,secretary determines appropriate2 and 7#d7 such professionals and facilities shall provide-- 7,a7 directly1 or through the use of telehealth technology1 and pursuant to ,federal and ,state law1 counseling by a program counselor or other certified professional who is licensed and qualified by education1 training1 or experience to assess the psychological and sociological background of patients1 to contribute to the appropriate treatment plan for the patient1 and to monitor progress2 and 7,b7 medication-assisted treatment1 including1 to the extent practicable1 all drugs approved by the ,food and ,drug ,administration to treat substance use disorders1 pursuant to ,federal and ,state law4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #be1jjj1jjj for each of fiscal years #bjai through #bjbc4 #adah4 ,protecting moms and infants 7a7 ,report 7#a7 ,in general ,not later than #fj days after the date of enactment of this ,act1 the ,secretary shall submit to the appropriate committees of ,congress and make available to the public on the internet website of the ,department of ,health and ,human ,services a report regarding the implementation of the recommendations in the strategy relating to prenatal opioid use1 including neonatal abstinence syndrome1 developed pursuant to section #b of the ,protecting ,our ,infants ,act of #bjae 7,public ,law #aad-ia74 ,such report shall include-- 7,a7 an update on the implementation of the recommendations in the strategy1 including information regarding the agencies involved in the implementation2 and 7,b7 information on additional funding or authority the ,secretary requires1 if any1 to implement the strategy1 which may include authorities needed to coordinate implementation of such strategy across the ,department of ,health and ,human ,services4 7#b7 ,periodic updates ,the ,secretary shall periodically update the report under paragraph 7#a74 7b7 ,residential treatment programs for pregnant and postpartum women ,section #ejh7s7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7s77 is amended by striking #af1ijj1jjj for each of fiscal years #bjag through #bjba and inserting #bi1ica1jjj for each of fiscal years #bjai through #bjbc4 #adai4 ,early interventions for pregnant women and infants 7a7 ,development of educational materials by ,center for ,substance ,abuse ,prevention ,section #eae7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#ba7;b77 is amended-- 7#a7 in paragraph 7#ac71 by striking and at the end2 7#b7 in paragraph 7#ad71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#ae7 in cooperation with relevant stakeholders and the ,director of the ,centers for ,disease ,control and ,prevention1 develop educational materials for clinicians to use with pregnant women for shared decisionmaking regarding pain management during pregnancy4 4 7b7 ,guidelines and recommendations by ,center for ,substance ,abuse ,treatment ,section #ejg7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb7b77 is amended-- 7#a7 in paragraph 7#ac71 by striking and at the end2 7#b7 in paragraph 7#ad71 by striking the period at the end and inserting a semicolon2 and 7#c7 by adding at the end the following3 7#ae7 in cooperation with the ,secretary1 implement and disseminate1 as appropriate1 the recommendations in the report entitled ,protecting ,our ,infants ,act3 ,final ,strategy issued by the ,department of ,health and ,human ,services in #bjag2 and 4 7c7 ,support of partnerships by ,center for ,substance ,abuse ,treatment ,section #ejg7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb7b771 as amended by subsection 7b71 is further amended by adding at the end the following3 7#af7 in cooperation with relevant stakeholders1 support public-private partnerships to assist with education about1 and support with respect to1 substance use disorder for pregnant women and health care providers who treat pregnant women and babies4 4 #adbj4 ,report on investigations regarding parity in mental health and substance use disorder benefits 7a7 ,in general ,section #acjjc of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 is amended-- 7#a7 in subsection 7a71 by striking with findings of any serious violation regarding and inserting concerning2 and 7#b7 in subsection 7b77#a7-- 7,a7 by inserting complaints received and number of before closed2 and 7,b7 by inserting before the period 1 and1 for each such investigation closed1 which agency conducted the investigation1 whether the health plan that is the subject of the investigation is fully insured or not fully insured and a summary of any coordination between the applicable ,state regulators and the ,department of ,labor1 the ,department of ,health and ,human ,services1 or the ,department of the ,treasury1 and references to any guidance provided by the agencies addressing the category of violation committed4 7b7 ,applicability ,the amendments made by subsection 7a7 shall apply with respect to the second annual report required under such section #acjjc and each such annual report thereafter4 ,e ,prevention #aeja4 ,study on prescribing limits ,not later than #b years after the date of enactment of this ,act1 the ,secretary1 in consultation with the ,attorney ,general1 shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report on the impact of ,federal and ,state laws and regulations that limit the length1 quantity1 or dosage of opioid prescriptions4 ,such report shall address-- 7#a7 the impact of such limits on-- 7,a7 the incidence and prevalence of overdose related to prescription opioids2 7,b7 the incidence and prevalence of overdose related to illicit opioids2 7,c7 the prevalence of opioid use disorders2 7,d7 medically appropriate use of1 and access to1 opioids1 including any impact on travel expenses and pain management outcomes for patients1 whether such limits are associated with significantly higher rates of negative health outcomes1 including suicide1 and whether the impact of such limits differs based on the clinical indication for which opioids are prescribed2 7#b7 whether such limits lead to a significant increase in burden for prescribers of opioids or prescribers of treatments for opioid use disorder1 including any impact on patient access to treatment1 and whether any such burden is mitigated by any factors such as electronic prescribing or telemedicine2 and 7#c7 the impact of such limits on diversion or misuse of any controlled substance in schedule ,,ii1 ,,iii1 or ,,iv of section #bjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hab7;c774 #aejb4 ,programs for health care workforce 7a7 ,program for education and training in pain care ,section #gei of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;i7 is amended-- 7#a7 in subsection 7a71 by striking hospices1 and other public and private entities and inserting hospices1 tribal health programs 7as defined in section #d of the ,indian ,health ,care ,improvement ,act71 and other public and nonprofit private entities2 7#b7 in subsection 7b7-- 7,a7 in the matter preceding paragraph 7#a71 by striking award may be made under subsection 7a7 only if the applicant for the award agrees that the program carried out with the award will include and inserting entity receiving an award under this section shall develop a comprehensive education and training plan that includes2 7,b7 in paragraph 7#a7-- 7i7 by inserting preventing1 after diagnosing12 and 7ii7 by inserting non-addictive medical products and non-pharmacologic treatments and after including2 7,c7 in paragraph 7#b7-- 7i7 by inserting ,federal1 ,state1 and local after applicable2 and 7ii7 by striking the degree to which and all that follows through effective pain care and inserting opioids2 7,d7 in paragraph 7#c71 by inserting 1 integrated1 evidence-based pain management1 and1 as appropriate1 non-pharmacotherapy before the semicolon2 7,e7 in paragraph 7#d71 by striking 2 and and inserting 22 and 7,f7 by striking paragraph 7#e7 and inserting the following3 7#e7 recent findings1 developments1 and advancements in pain care research and the provision of pain care1 which may include non-addictive medical products and non-pharmacologic treatments intended to treat pain2 and 7#f7 the dangers of opioid abuse and misuse1 detection of early warning signs of opioid use disorders 7which may include best practices related to screening for opioid use disorders1 training on screening1 brief intervention1 and referral to treatment71 and safe disposal options for prescription medications 7including such options provided by law enforcement or other innovative deactivation mechanisms74 2 7#c7 in subsection 7d71 by inserting prevention1 after diagnosis12 and 7#d7 in subsection 7e71 by striking #bjaj through #bjab and inserting #bjai through #bjbc4 7b7 ,mental and behavioral health education and training program ,section #gef7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e-#a7;a77 is amended-- 7#a7 in paragraph 7#a71 by inserting 1 trauma1 after focus on child and adolescent mental health2 and 7#b7 in paragraphs 7#b7 and 7#c71 by inserting trauma-informed care and before substance use disorder prevention and treatment services4 #aejc4 ,education and awareness campaigns ,section #ajb of the ,comprehensive ,addiction and ,recovery ,act of #bjaf 7,public ,law #aad-aih7 is amended-- 7#a7 by amending subsection 7a7 to read as follows3 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention and in coordination with the heads of other departments and agencies1 shall advance education and awareness regarding the risks related to misuse and abuse of opioids1 as appropriate1 which may include developing or improving existing programs1 conducting activities1 and awarding grants that advance the education and awareness of-- 7#a7 the public1 including patients and consumers2 7#b7 patients1 consumers1 and other appropriate members of the public1 regarding such risks related to unused opioids and the dispensing options under section #cji7;f7 of the ,controlled ,substances ,act1 as applicable2 7#c7 providers1 which may include-- 7,a7 providing for continuing education on appropriate prescribing practices2 7,b7 education related to applicable ,state or local prescriber limit laws1 information on the use of non-addictive alternatives for pain management1 and the use of overdose reversal drugs1 as appropriate2 7,c7 disseminating and improving the use of evidence-based opioid prescribing guidelines across relevant health care settings1 as appropriate1 and updating guidelines as necessary2 7,d7 implementing strategies1 such as best practices1 to encourage and facilitate the use of prescriber guidelines1 in accordance with ,state and local law2 7,e7 disseminating information to providers about prescribing options for controlled substances1 including such options under section #cji7;f7 of the ,controlled ,substances ,act1 as applicable2 and 7,f7 disseminating information1 as appropriate1 on the ,national ,pain ,strategy developed by or in consultation with the ,assistant ,secretary for ,health2 and 7#d7 other appropriate entities4 2 and 7#b7 in subsection 7b7-- 7,a7 by striking opioid abuse each place such term appears and inserting opioid misuse and abuse2 and 7,b7 in paragraph 7#b71 by striking safe disposal of prescription medications and other and inserting non-addictive treatment options1 safe disposal options for prescription medications1 and other applicable4 #aejd4 ,enhanced controlled substance overdoses data collection1 analysis1 and dissemination ,part ,j of title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #cib 7#db ,u4,s4,c4 #bhj;b-#a7 the following3 #cib;,a4 ,enhanced controlled substance overdoses data collection1 analysis1 and dissemination 7a7 ,in general ,the ,director of the ,centers for ,disease ,control and ,prevention1 using the authority provided to the ,director under section #cib1 may-- 7#a7 to the extent practicable1 carry out and expand any controlled substance overdose data collection1 analysis1 and dissemination activity described in subsection 7b72 7#b7 provide training and technical assistance to ,states1 localities1 and ,indian ,tribes for the purpose of carrying out any such activity2 and 7#c7 award grants to ,states1 localities1 and ,indian ,tribes for the purpose of carrying out any such activity4 7b7 ,controlled substance overdose data collection and analysis activities ,a controlled substance overdose data collection1 analysis1 and dissemination activity described in this subsection is any of the following activities3 7#a7 ,improving the timeliness of reporting aggregate data to the public1 including data on fatal and nonfatal controlled substance overdoses4 7#b7 ,enhancing the comprehensiveness of controlled substance overdose data by collecting information on such overdoses from appropriate sources such as toxicology reports1 autopsy reports1 death scene investigations1 and emergency department services4 7#c7 ,modernizing the system for coding causes of death related to controlled substance overdoses to use an electronic-based system4 7#d7 ,using data to help identify risk factors associated with controlled substance overdoses1 including the delivery of certain health care services4 7#e7 ,supporting entities involved in reporting information on controlled substance overdoses1 such as coroners and medical examiners1 to improve accurate testing and standardized reporting of causes and contributing factors of such overdoses1 and analysis of various opioid analogues to controlled substance overdoses4 7#f7 ,working to enable and encourage the access1 exchange1 and use of data regarding controlled substances overdoses among data sources and entities4 7c7 ,definitions ,in this section-- 7#a7 the term controlled substance has the meaning given that term in section #ajb of the ,controlled ,substances ,act2 and 7#b7 the term ,indian ,tribe has the meaning given the term ,indian tribe in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 4 #aeje4 ,preventing overdoses of controlled substances ,part ,j of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b et seq471 as amended by section #ejd1 is further amended by inserting after section #cib;,a the following3 #cib;,b4 ,preventing overdoses of controlled substances 7a7 ,prevention activities 7#a7 ,in general ,the ,director of the ,centers for ,disease ,control and ,prevention 7referred to in this section as the ,director71 using the authority provided to the ,director under section #cib1 may-- 7,a7 to the extent practicable1 carry out and expand any prevention activity described in paragraph 7#b72 7,b7 provide training and technical assistance to ,states1 localities1 and ,indian ,tribes to carry out any such activity2 and 7,c7 award grants to ,states1 localities1 and ,indian ,tribes for the purpose of carrying out any such activity4 7#b7 ,prevention activities ,a prevention activity described in this paragraph is an activity to improve the efficiency and use of a new or currently operating prescription drug monitoring program1 such as-- 7,a7 encouraging all authorized users 7as specified by the ,state or other entity7 to register with and use the program2 7,b7 enabling such users to access any data updates in as close to real-time as practicable2 7,c7 providing for a mechanism for the program to notify authorized users of any potential misuse or abuse of controlled substances and any detection of inappropriate prescribing or dispensing practices relating to such substances2 7,d7 encouraging the analysis of prescription drug monitoring data for purposes of providing de-identified1 aggregate reports based on such analysis to ,state public health agencies1 ,state alcohol and drug agencies1 ,state licensing boards1 and other appropriate ,state agencies1 as permitted under applicable ,federal and ,state law and the policies of the prescription drug monitoring program and not containing any protected health information1 to prevent inappropriate prescribing1 drug diversion1 or abuse and misuse of controlled substances1 and to facilitate better coordination among agencies2 7,e7 enhancing interoperability between the program and any health information technology 7including certified health information technology71 including by integrating program data into such technology2 7,f7 updating program capabilities to respond to technological innovation for purposes of appropriately addressing the occurrence and evolution of controlled substance overdoses2 7,g7 developing or enhancing data exchange with other sources such as the ,medicaid agency1 the ,medicare program1 pharmacy benefit managers1 coroners' reports1 and workers' compensation data2 7,h7 facilitating and encouraging data exchange between the program and the prescription drug monitoring programs of other ,states2 7,i7 enhancing data collection and quality1 including improving patient matching and proactively monitoring data quality2 and 7,j7 providing prescriber and dispenser practice tools1 including prescriber practice insight reports for practitioners to review their prescribing patterns in comparison to such patters of other practitioners in the specialty4 7b7 ,additional grants ,the ,director may award grants to ,states1 localities1 and ,indian ,tribes-- 7#a7 to carry out innovative projects for grantees to rapidly respond to controlled substance misuse1 abuse1 and overdoses1 including changes in patterns of controlled substance use2 and 7#b7 for any other evidence-based activity for preventing controlled substance misuse1 abuse1 and overdoses as the ,director determines appropriate4 7c7 ,research ,the ,director1 in coordination with the ,assistant ,secretary for ,mental ,health and ,substance ,use and the ,national ,mental ,health and ,substance ,use ,policy ,laboratory established under section #eja;,a1 as appropriate and applicable1 may conduct studies and evaluations to address substance use disorders1 including preventing substance use disorders or other related topics the ,director determines appropriate4 7d7 ,public and prescriber education ,pursuant to section #ajb of the ,comprehensive ,addiction and ,recovery ,act of #bjaf1 the ,director may advance the education and awareness of prescribers and the public regarding the risk of abuse and misuse of prescription opioids4 7e7 ,definitions ,in this section-- 7#a7 the term controlled substance has the meaning given that term in section #ajb of the ,controlled ,substances ,act2 and 7#b7 the term ,indian ,tribe has the meaning given the term ,indian tribe in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7f7 ,authorization of appropriations ,for purposes of carrying out this section1 section #cib;,a of this ,act1 and section #ajb of the ,comprehensive ,addiction and ,recovery ,act of #bjaf1 there is authorized to be appropriated #dhf1jjj1jjj for each of fiscal years #bjai through #bjbd4 4 #aejf4 ,,cdc surveillance and data collection for child1 youth1 and adult trauma 7a7 ,data collection ,the ,director of the ,centers for ,disease ,control and ,prevention 7referred to in this section as the ,director7 may1 in cooperation with the ,states1 collect and report data on adverse childhood experiences through the ,behavioral ,risk ,factor ,surveillance ,system1 the ,youth ,risk ,behavior ,surveillance ,system1 and other relevant public health surveys or questionnaires4 7b7 ,timing ,the collection of data under subsection 7a7 may occur in fiscal year #bjai and every #b years thereafter4 7c7 ,data from rural areas ,the ,director shall encourage each ,state that participates in collecting and reporting data under subsection 7a7 to collect and report data from tribal and rural areas within such ,state1 in order to generate a statistically reliable representation of such areas4 7d7 ,data from tribal areas ,the ,director may1 in cooperation with ,indian ,tribes and pursuant to a written request from an ,indian ,tribe1 provide technical assistance to such ,indian ,tribe to collect and report data on adverse childhood experiences through the ,behavioral ,risk ,factor ,surveillance ,system1 the ,youth ,risk ,behavior ,surveillance ,system1 or another relevant public health survey or questionnaire4 7e7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated such sums as may be necessary for the period of fiscal years #bjai through #bjba4 #aejg4 ,reauthorization of ,,nasper ,section #cii,o of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#c7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a71 in the matter preceding subparagraph 7,a71 by striking in consultation with the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration and ,director of the ,centers for ,disease ,control and ,prevention and inserting in coordination with the ,director of the ,centers for ,disease ,control and the heads of other departments and agencies as appropriate2 and 7,b7 by adding at the end the following3 7#d7 ,states and local governments 7,a7 ,in general ,in the case of a ,state that does not have a prescription drug monitoring program1 a county or other unit of local government within the ,state that has a prescription drug monitoring program shall be treated as a ,state for purposes of this section1 including for purposes of eligibility for grants under paragraph 7#a74 7,b7 ,plan for interoperability ,for purposes of meeting the interoperability requirements under subsection 7c77#c71 a county or other unit of local government shall submit a plan outlining the methods such county or unit of local government will use to ensure the capability of data sharing with other counties and units of local government within the ,state and with other ,states1 as applicable4 2 7#b7 in subsection 7c7-- 7,a7 in paragraph 7#a77;,a77iii7-- 7i7 by inserting as such standards become available1 after interoperability standards12 and 7ii7 by striking generated or identified by the ,secretary or his or her designee and inserting recognized by the ,office of the ,national ,coordinator for ,health ,information ,technology2 and 7,b7 in paragraph 7#c77;,a71 by inserting including electronic health records1 after technology systems12 7#c7 in subsection 7d77#a71 by striking not later than #a week after the date of such dispensing and inserting in as close to real time as practicable2 7#d7 in subsection 7f7-- 7,a7 in paragraph 7#a77;,d71 by striking medicaid and inserting ,medicaid2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,a71 by striking and at the end2 7ii7 in subparagraph 7,b71 by striking the period and inserting a semicolon2 and 7iii7 by adding at the end the following3 7,c7 may conduct analyses of controlled substance program data for purposes of providing appropriate ,state agencies with aggregate reports based on such analyses in as close to real-time as practicable1 regarding prescription patterns flagged as potentially presenting a risk of misuse1 abuse1 addiction1 overdose1 and other aggregate information1 as appropriate and in compliance with applicable ,federal and ,state laws and provided that such reports shall not include protected health information2 and 7,d7 may access information about prescriptions1 such as claims data1 to ensure that such prescribing and dispensing history is updated in as close to real-time as practicable1 in compliance with applicable ,federal and ,state laws and provided that such information shall not include protected health information4 2 7#e7 in subsection 7i71 by inserting 1 in collaboration with the ,national ,coordinator for ,health ,information ,technology and the ,director of the ,national ,institute of ,standards and ,technology1 after ,the ,secretary2 and 7#f7 in subsection 7n71 by striking #bjba and inserting #bjbf4 #aejh4 ,jessie's law 7a7 ,best practices 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary1 in consultation with appropriate stakeholders1 including a patient with a history of opioid use disorder1 an expert in electronic health records1 an expert in the confidentiality of patient health information and records1 and a health care provider1 shall identify or facilitate the development of best practices regarding-- 7,a7 the circumstances under which information that a patient has provided to a health care provider regarding such patient's history of opioid use disorder should1 only at the patient's request1 be prominently displayed in the medical records 7including electronic health records7 of such patient2 7,b7 what constitutes the patient's request for the purpose described in subparagraph 7,a72 and 7,c7 the process and methods by which the information should be so displayed4 7#b7 ,dissemination ,the ,secretary shall disseminate the best practices developed under paragraph 7#a7 to health care providers and ,state agencies4 7b7 ,requirements ,in identifying or facilitating the development of best practices under subsection 7a71 as applicable1 the ,secretary1 in consultation with appropriate stakeholders1 shall consider the following3 7#a7 ,the potential for addiction relapse or overdose1 including overdose death1 when opioid medications are prescribed to a patient recovering from opioid use disorder4 7#b7 ,the benefits of displaying information about a patient's opioid use disorder history in a manner similar to other potentially lethal medical concerns1 including drug allergies and contraindications4 7#c7 ,the importance of prominently displaying information about a patient's opioid use disorder when a physician or medical professional is prescribing medication1 including methods for avoiding alert fatigue in providers4 7#d7 ,the importance of a variety of appropriate medical professionals1 including physicians1 nurses1 and pharmacists1 having access to information described in this section when prescribing or dispensing opioid medication1 consistent with ,federal and ,state laws and regulations4 7#e7 ,the importance of protecting patient privacy1 including the requirements related to consent for disclosure of substance use disorder information under all applicable laws and regulations4 7#f7 ,all applicable ,federal and ,state laws and regulations4 #aeji4 ,development and dissemination of model training programs for substance use disorder patient records 7a7 ,initial programs and materials ,not later than #a year after the date of the enactment of this ,act1 the ,secretary1 in consultation with appropriate experts1 shall identify the following model programs and materials 7or if no such programs or materials exist1 recognize private or public entities to develop and disseminate such programs and materials73 7#a7 ,model programs and materials for training health care providers 7including physicians1 emergency medical personnel1 psychiatrists1 psychologists1 counselors1 therapists1 nurse practitioners1 physician assistants1 behavioral health facilities and clinics1 care managers1 and hospitals1 including individuals such as general counsels or regulatory compliance staff who are responsible for establishing provider privacy policies7 concerning the permitted uses and disclosures1 consistent with the standards and regulations governing the privacy and security of substance use disorder patient records promulgated by the ,secretary under section #edc of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd-#b7 for the confidentiality of patient records4 7#b7 ,model programs and materials for training patients and their families regarding their rights to protect and obtain information under the standards and regulations described in paragraph 7#a74 7b7 ,requirements ,the model programs and materials described in paragraphs 7#a7 and 7#b7 of subsection 7a7 shall address circumstances under which disclosure of substance use disorder patient records is needed to-- 7#a7 facilitate communication between substance use disorder treatment providers and other health care providers to promote and provide the best possible integrated care2 7#b7 avoid inappropriate prescribing that can lead to dangerous drug interactions1 overdose1 or relapse2 and 7#c7 notify and involve families and caregivers when individuals experience an overdose4 7c7 ,periodic updates ,the ,secretary shall-- 7#a7 periodically review and update the model program and materials identified or developed under subsection 7a72 and 7#b7 disseminate such updated programs and materials to the individuals described in subsection 7a77#a74 7d7 ,input of certain entities ,in identifying1 reviewing1 or updating the model programs and materials under this section1 the ,secretary shall solicit the input of relevant stakeholders4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #aeaj4 ,communication with families during emergencies 7a7 ,promoting ,awareness of ,authorized ,disclosures during ,emergencies ,the ,secretary shall annually notify health care providers regarding permitted disclosures during emergencies1 including overdoses1 of certain health information to families and caregivers under ,federal health care privacy laws and regulations4 7b7 ,use of material ,for the purposes of carrying out subsection 7a71 the ,secretary may use material produced under section #aeji of this ,act or under section #aajjd of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #acbj;d-#b note74 #aeaa4 ,prenatal and postnatal health ,section #cag,l of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by amending paragraph 7#a7 to read as follows3 7#a7 to collect1 analyze1 and make available data on prenatal smoking and alcohol and substance abuse and misuse1 including-- 7,a7 data on-- 7i7 the incidence1 prevalence1 and implications of such activities2 and 7ii7 the incidence and prevalence of implications and outcomes1 including neonatal abstinence syndrome and other maternal and child health outcomes associated with such activities2 and 7,b7 to inform such analysis1 additional information or data on family health history1 medication exposures during pregnancy1 demographic information1 such as race1 ethnicity1 geographic location1 and family history1 and other relevant information1 as appropriate2 2 7,b7 in paragraph 7#b7-- 7i7 by striking prevention of and inserting prevention and long-term outcomes associated with2 and 7ii7 by striking illegal drug use and inserting substance abuse and misuse2 7,c7 in paragraph 7#c71 by striking and cessation programs2 and and inserting 1 treatment1 and cessation programs22 7,d7 in paragraph 7#d71 by striking illegal drug use4 and inserting substance abuse and misuse2 and2 and 7,e7 by adding at the end the following3 7#e7 to issue public reports on the analysis of data described in paragraph 7#a71 including analysis of-- 7,a7 long-term outcomes of children affected by neonatal abstinence syndrome2 7,b7 health outcomes associated with prenatal smoking1 alcohol1 and substance abuse and misuse2 and 7,c7 relevant studies1 evaluations1 or information the ,secretary determines to be appropriate4 2 7#b7 in subsection 7b71 by inserting tribal entities1 after local governments12 7#c7 by redesignating subsection 7c7 as subsection 7d72 7#d7 by inserting after subsection 7b7 the following3 7c7 ,coordinating activities ,to carry out this section1 the ,secretary may-- 7#a7 provide technical and consultative assistance to entities receiving grants under subsection 7b72 7#b7 ensure a pathway for data sharing between ,states1 tribal entities1 and the ,centers for ,disease ,control and ,prevention2 7#c7 ensure data collection under this section is consistent with applicable ,state1 ,federal1 and ,tribal privacy laws2 and 7#d7 coordinate with the ,national ,coordinator for ,health ,information ,technology1 as appropriate1 to assist ,states and ,tribes in implementing systems that use standards recognized by such ,national ,coordinator1 as such recognized standards are available1 in order to facilitate interoperability between such systems and health information technology systems1 including certified health information technology4 2 and 7#e7 in subsection 7d71 as so redesignated1 by striking #bjja through #bjje and inserting #bjai through #bjbc4 #aeab4 ,surveillance and education regarding infections associated with illicit drug use and other risk factors ,section #cag,n of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ae7 is amended-- 7#a7 by amending the section heading to read as follows3 ,surveillance and education regarding infections associated with illicit drug use and other risk factors2 7#b7 in subsection 7a7-- 7,a7 in the matter preceding paragraph 7#a71 by inserting activities before the colon2 7,b7 in paragraph 7#a7-- 7i7 by inserting or maintaining after implementing2 7ii7 by striking hepatitis ,c virus infection 7in this section referred to as ,,hcv infection7 and inserting infections commonly associated with illicit drug use1 which may include viral hepatitis1 human immunodeficiency virus1 and infective endocarditis12 and 7iii7 by striking such infection and all that follows through the period at the end and inserting such infections1 which may include the reporting of cases of such infections42 7,c7 in paragraph 7#b71 by striking ,,hcv infection and all that follows through the period at the end and inserting infections as a result of illicit drug use1 receiving blood transfusions prior to ,july #aiib1 or other risk factors42 7,d7 in paragraphs 7#d7 and 7#e71 by striking ,,hcv infection each place such term appears and inserting infections described in paragraph 7#a72 and 7,e7 in paragraph 7#e71 by striking pediatricians and other primary care physicians1 and obstetricians and gynecologists and inserting substance use disorder treatment providers1 pediatricians1 other primary care providers1 and obstetrician-gynecologists2 7#c7 in subsection 7b7-- 7,a7 by striking directly and and inserting directly or2 and 7,b7 by striking hepatitis ,c1 and all that follows through the period at the end and inserting infections described in subsection 7a77#a742 and 7#d7 in subsection 7c71 by striking such sums as may be necessary for each of the fiscal years #bjja through #bjje and inserting #dj1jjj1jjj for each of fiscal years #bjai through #bjbc4 #aeac4 ,task force to develop best practices for trauma-informed identification1 referral1 and support 7a7 ,establishment ,there is established a task force1 to be known as the ,interagency ,task ,force on ,trauma-,informed ,care 7in this section referred to as the task force7 that shall identify1 evaluate1 and make recommendations regarding best practices with respect to children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma4 7b7 ,membership 7#a7 ,composition ,the task force shall be composed of the heads of the following ,federal departments and agencies1 or their designees3 7,a7 ,the ,centers for ,medicare ,medicaid ,services4 7,b7 ,the ,substance ,abuse and ,mental ,health ,services ,administration4 7,c7 ,the ,agency for ,healthcare ,research and ,quality4 7,d7 ,the ,centers for ,disease ,control and ,prevention4 7,e7 ,the ,indian ,health ,service4 7,f7 ,the ,department of ,veterans ,affairs4 7,g7 ,the ,national ,institutes of ,health4 7,h7 ,the ,food and ,drug ,administration4 7,i7 ,the ,health ,resources and ,services ,administration4 7,j7 ,the ,department of ,defense4 7,k7 ,the ,office of ,minority ,health4 7,l7 ,the ,administration for ,children and ,families4 7,m7 ,the ,office of the ,assistant ,secretary for ,planning and ,evaluation4 7,n7 ,the ,office for ,civil ,rights of the ,department of ,health and ,human ,services4 7,o7 ,the ,office of ,juvenile ,justice and ,delinquency ,prevention of the ,department of ,justice4 7,p7 ,the ,office of ,community ,oriented ,policing ,services of the ,department of ,justice4 7,q7 ,the ,office on ,violence ,against ,women of the ,department of ,justice4 7,r7 ,the ,national ,center for ,education ,evaluation and ,regional ,assistance of the ,department of ,education4 7,s7 ,the ,national ,center for ,special ,education ,research of the ,institute of ,education ,science4 7,t7 ,the ,office of ,elementary and ,secondary ,education of the ,department of ,education4 7,u7 ,the ,office for ,civil ,rights of the ,department of ,education4 7,v7 ,the ,office of ,special ,education and ,rehabilitative ,services of the ,department of ,education4 7,w7 ,the ,bureau of ,indian ,affairs of the ,department of the ,interior4 7,x7 ,the ,veterans ,health ,administration of the ,department of ,veterans ,affairs4 7,y7 ,the ,office of ,special ,needs ,assistance ,programs of the ,department of ,housing and ,urban ,development4 7,z7 ,the ,office of ,head ,start of the ,administration for ,children and ,families4 7,,aa7 ,the ,children's ,bureau of the ,administration for ,children and ,families4 7,,bb7 ,the ,bureau of ,indian ,education of the ,department of the ,interior4 7,,cc7 ,such other ,federal agencies as the ,secretaries determine to be appropriate4 7#b7 ,date of appointments ,the heads of ,federal departments and agencies shall appoint the corresponding members of the task force not later than #f months after the date of enactment of this ,act4 7#c7 ,chairperson ,the task force shall be chaired by the ,assistant ,secretary for ,mental ,health and ,substance ,use4 7c7 ,task force duties ,the task force shall-- 7#a7 solicit input from stakeholders1 including frontline service providers1 educators1 mental health professionals1 researchers1 experts in infant1 child1 and youth trauma1 child welfare professionals1 and the public1 in order to inform the activities under paragraph 7#b72 and 7#b7 identify1 evaluate1 make recommendations1 and update such recommendations not less than annually1 to the general public1 the ,secretary of ,education1 the ,secretary of ,health and ,human ,services1 the ,secretary of ,labor1 the ,secretary of the ,interior1 the ,attorney ,general1 and other relevant cabinet ,secretaries1 and ,congress regarding-- 7,a7 a set of evidence-based1 evidence-informed1 and promising best practices with respect to-- 7i7 the identification of infants1 children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 and 7ii7 the expeditious referral to and implementation of trauma-informed practices and supports that prevent and mitigate the effects of trauma2 7,b7 a national strategy on how the task force and member agencies will collaborate1 prioritize options for1 and implement a coordinated approach which may include data sharing and the awarding of grants that support infants1 children1 and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 and 7,c7 existing ,federal authorities at the ,department of ,education1 ,department of ,health and ,human ,services1 ,department of ,justice1 ,department of ,labor1 ,department of the ,interior1 and other relevant agencies1 and specific ,federal grant programs to disseminate best practices on1 provide training in1 or deliver services through1 trauma-informed practices1 and disseminate such information-- 7i7 in writing to relevant program offices at such agencies to encourage grant applicants in writing to use such funds1 where appropriate1 for trauma-informed practices2 and 7ii7 to the general public through the internet website of the task force4 7d7 ,best practices ,in identifying1 evaluating1 and recommending the set of best practices under subsection 7c71 the task force shall-- 7#a7 include guidelines for providing professional development for front-line services providers1 including school personnel1 early childhood education program providers1 providers from child- or youth-serving organizations1 housing and homeless providers1 primary and behavioral health care providers1 child welfare and social services providers1 juvenile and family court personnel1 health care providers1 individuals who are mandatory reporters of child abuse or neglect1 trained nonclinical providers 7including peer mentors and clergy71 and first responders1 in-- 7,a7 understanding and identifying early signs and risk factors of trauma in infants1 children1 and youth1 and their families as appropriate1 including through screening processes2 7,b7 providing practices to prevent and mitigate the impact of trauma1 including by fostering safe and stable environments and relationships2 and 7,c7 developing and implementing policies1 procedures1 or systems that-- 7i7 are designed to quickly refer infants1 children1 youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma to the appropriate trauma-informed screening and support1 including age-appropriate treatment1 and to ensure such infants1 children1 youth1 and family members receive such support2 7ii7 utilize and develop partnerships with early childhood education programs1 local social services organizations1 such as organizations serving youth1 and clinical mental health or health care service providers with expertise in providing support services 7including age-appropriate trauma-informed and evidence-based treatment7 aimed at preventing or mitigating the effects of trauma2 7iii7 educate children and youth to-- 7,i7 understand and identify the signs1 effects1 or symptoms of trauma2 and 7,,ii7 build the resilience and coping skills to mitigate the effects of experiencing trauma2 7iv7 promote and support multi-generational practices that assist parents1 foster parents1 and kinship and other caregivers in accessing resources related to1 and developing environments conducive to1 the prevention and mitigation of trauma2 and 7v7 collect and utilize data from screenings1 referrals1 or the provision of services and supports to evaluate and improve processes for trauma-informed support and outcomes that are culturally sensitive1 linguistically appropriate1 and specific to age ranges and sex1 as applicable2 and 7#b7 recommend best practices that are designed to avoid unwarranted custody loss or criminal penalties for parents or guardians in connection with infants1 children1 and youth who have experienced or are at risk of experiencing trauma4 7e7 ,operating plan ,not later than #a year after the date of enactment of this ,act1 the task force shall hold the first meeting4 ,not later than #b years after such date of enactment1 the task force shall submit to the ,secretary of ,education1 ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 ,secretary of the ,interior1 the ,attorney ,general1 and ,congress an operating plan for carrying out the activities of the task force described in subsection 7c77#b74 ,such operating plan shall include-- 7#a7 a list of specific activities that the task force plans to carry out for purposes of carrying out duties described in subsection 7c77#b71 which may include public engagement2 7#b7 a plan for carrying out the activities under subsection 7c77#b72 7#c7 a list of members of the task force and other individuals who are not members of the task force that may be consulted to carry out such activities2 7#d7 an explanation of ,federal agency involvement and coordination needed to carry out such activities1 including any statutory or regulatory barriers to such coordination2 7#e7 a budget for carrying out such activities2 and 7#f7 other information that the task force determines appropriate4 7f7 ,final report ,not later than #c years after the date of the first meeting of the task force1 the task force shall submit to the general public1 ,secretary of ,education1 ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 ,secretary of the ,interior1 the ,attorney ,general1 and other relevant cabinet ,secretaries1 and ,congress1 a final report containing all of the findings and recommendations required under this section4 7g7 ,definition ,in this section1 the term early childhood education program has the meaning given such term in section #ajc of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajjc74 7h7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated such sums as may be necessary for each of fiscal years #bjai through #bjbb4 7i7 ,sunset ,the task force shall on the date that is #fj days after the submission of the final report under subsection 7f71 but not later than ,september #cj1 #bjbb4 #aead4 ,grants to improve trauma support services and mental health care for children and youth in educational settings 7a7 ,grants1 contracts1 and cooperative agreements authorized ,the ,secretary1 in coordination with the ,assistant ,secretary for ,mental ,health and ,substance ,use1 is authorized to award grants to1 or enter into contracts or cooperative agreements with1 ,state educational agencies1 local educational agencies1 ,head ,start agencies 7including ,early ,head ,start agencies71 ,state or local agencies that administer public preschool programs1 ,indian ,tribes or their tribal educational agencies1 a school operated by the ,bureau of ,indian ,education1 a ,regional ,corporation 7as defined in section #c of the ,alaska ,native ,claims ,settlement ,act 7#dc ,u4,s4,c4 #afjb771 or a ,native ,hawaiian educational organization 7as defined in section #fbjg of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #geag771 for the purpose of increasing student access to evidence-based trauma support services and mental health care by developing innovative initiatives1 activities1 or programs to link local school systems with local trauma-informed support and mental health systems1 including those under the ,indian ,health ,service4 7b7 ,duration ,with respect to a grant1 contract1 or cooperative agreement awarded or entered into under this section1 the period during which payments under such grant1 contract or agreement are made to the recipient may not exceed #d years4 7c7 ,use of funds ,an entity that receives a grant1 contract1 or cooperative agreement under this section shall use amounts made available through such grant1 contract1 or cooperative agreement for evidence-based activities1 which shall include any of the following3 7#a7 ,collaborative efforts between school-based service systems and trauma-informed support and mental health service systems to provide1 develop1 or improve prevention1 screening1 referral1 and treatment and support services to students1 such as by providing universal trauma screenings to identify students in need of specialized support4 7#b7 ,to implement schoolwide multi-tiered positive behavioral interventions and supports1 or other trauma-informed models of support4 7#c7 ,to provide professional development to teachers1 teacher assistants1 school leaders1 specialized instructional support personnel1 and mental health professionals that-- 7,a7 fosters safe and stable learning environments that prevent and mitigate the effects of trauma1 including through social and emotional learning2 7,b7 improves school capacity to identify1 refer1 and provide services to students in need of trauma support or behavioral health services2 or 7,c7 reflects the best practices developed by the ,interagency ,task ,force on ,trauma-,informed ,care established under section #eac4 7#d7 ,to create or enhance services at a full-service community school that focuses on trauma-informed supports1 which may include establishing a school-site advisory team1 managing1 coordinating1 or delivering pipeline services1 hiring a full-time site coordinator1 or other activities consistent with section #dfbe of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gbge74 7#e7 ,engaging families and communities in efforts to increase awareness of child and youth trauma1 which may include sharing best practices with law enforcement regarding trauma-informed care and working with mental health professionals to provide interventions1 as well as longer term coordinated care within the community for children and youth who have experienced trauma and their families4 7#f7 ,to provide technical assistance to school systems and mental health agencies4 7#g7 ,to evaluate the effectiveness of the program carried out under this section in increasing student access to evidence-based trauma support services and mental health care4 7d7 ,applications ,to be eligible to receive a grant1 contract1 or cooperative agreement under this section1 an entity described in subsection 7a7 shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require1 which shall include the following3 7#a7 ,a description of the innovative initiatives1 activities1 or programs to be funded under the grant1 contract1 or cooperative agreement1 including how such program will increase access to evidence-based trauma support services and mental health care for students1 and1 as applicable1 the families of such students4 7#b7 ,a description of how the program will provide linguistically appropriate and culturally competent services4 7#c7 ,a description of how the program will support students and the school in improving the school climate in order to support an environment conducive to learning4 7#d7 ,an assurance that-- 7,a7 persons providing services under the grant1 contract1 or cooperative agreement are adequately trained to provide such services2 and 7,b7 teachers1 school leaders1 administrators1 specialized instructional support personnel1 representatives of local ,indian ,tribes or tribal organizations as appropriate1 other school personnel1 and parents or guardians of students participating in services under this section will be engaged and involved in the design and implementation of the services4 7#e7 ,a description of how the applicant will support and integrate existing school-based services with the program in order to provide mental health services for students1 as appropriate4 7e7 ,interagency agreements 7#a7 ,designation of lead agency ,a recipient of a grant1 contract1 or cooperative agreement under this section shall designate a lead agency to direct the establishment of an interagency agreement among local educational agencies1 agencies responsible for early childhood education programs1 juvenile justice authorities1 mental health agencies1 child welfare agencies1 and other relevant entities in the ,state or ,indian ,tribe1 in collaboration with local entities4 7#b7 ,contents ,the interagency agreement shall ensure the provision of the services described in subsection 7c71 specifying with respect to each agency1 authority1 or entity-- 7,a7 the financial responsibility for the services2 7,b7 the conditions and terms of responsibility for the services1 including quality1 accountability1 and coordination of the services2 and 7,c7 the conditions and terms of reimbursement among the agencies1 authorities1 or entities that are parties to the interagency agreement1 including procedures for dispute resolution4 7f7 ,evaluation ,the ,secretary shall reserve not to exceed #c percent of the funds made available under subsection 7l7 for each fiscal year to-- 7#a7 conduct a rigorous1 independent evaluation of the activities funded under this section2 and 7#b7 disseminate and promote the utilization of evidence-based practices regarding trauma support services and mental health care4 7g7 ,distribution of awards ,the ,secretary shall ensure that grants1 contracts1 and cooperative agreements awarded or entered into under this section are equitably distributed among the geographical regions of the ,united ,states and among tribal1 urban1 suburban1 and rural populations4 7h7 ,rule of construction ,nothing in this section shall be construed-- 7#a7 to prohibit an entity involved with a program carried out under this section from reporting a crime that is committed by a student to appropriate authorities2 or 7#b7 to prevent ,federal1 ,state1 and tribal law enforcement and judicial authorities from exercising their responsibilities with regard to the application of ,federal1 tribal1 and ,state law to crimes committed by a student4 7i7 ,supplement1 not supplant ,any services provided through programs carried out under this section shall supplement1 and not supplant1 existing mental health services1 including any special education and related services provided under the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adjj et seq474 7j7 ,consultation with indian ,tribes ,in carrying out subsection 7a71 the ,secretary shall1 in a timely manner1 meaningfully consult1 engage1 and cooperate with ,indian ,tribes and their representatives to ensure notice of eligibility4 7k7 ,definitions ,in this section3 7#a7 ,elementary or secondary school ,the term elementary or secondary school means a public elementary and secondary school as such term is defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#b7 ,evidence-based ,the term evidence-based has the meaning given such term in section #haja7ba77;,a77i7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja7ba77;,a77i774 7#c7 ,native ,hawaiian educational organization ,the term ,native ,hawaiian educational organization has the meaning given such term in section #fbjg of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #geag74 7#d7 ,pipeline services ,the term pipeline services has the meaning given such term in section #dfbb of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #geag74 7#e7 ,school leader ,the term school leader has the meaning given such term in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#f7 ,secretary ,the term ,secretary means the ,secretary of ,education4 7#g7 ,specialized instructional support personnel ,the term specialized instructional support personnel has the meaning given such term in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7l7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #aeae4 ,national ,child ,traumatic ,stress ,initiative ,section #ehb7;j7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7;j77 7relating to grants to address the problems of persons who experience violence-related stress7 is amended by striking #df1hhg1jjj for each of fiscal years #bjah through #bjbb and inserting #ec1hhg1jjj for each of fiscal years #bjai through #bjbc4 #aeaf4 ,national milestones to measure success in curtailing the opioid crisis 7a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary1 in consultation with the ,administrator of the ,drug ,enforcement ,administration and the ,director of the ,office of ,national ,drug ,control ,policy1 shall develop or identify existing national indicators 7referred to in this section as the national milestones7 to measure success in curtailing the opioid crisis1 with the goal of significantly reversing the incidence and prevalence of opioid misuse and abuse1 and opioid-related morbidity and mortality in the ,united ,states within #e years of such date of enactment4 7b7 ,national milestones to end the opioid crisis ,the national milestones under subsection 7a7 shall include the following3 7#a7 ,not fewer than #aj indicators or metrics to accurately and expediently measure progress in meeting the goal described in subsection 7a71 which shall1 as appropriate1 include1 indicators or metrics related to-- 7,a7 the number of fatal and non-fatal opioid overdoses2 7,b7 the number of emergency room visits related to opioid misuse and abuse2 7,c7 the number of individuals in sustained recovery from opioid use disorder2 7,d7 the number of infections associated with illicit drug use1 such as ,,hiv1 viral hepatitis1 and infective endocarditis1 and available capacity for treating such infections2 7,e7 the number of providers prescribing medication assisted treatment for opioid use disorders1 including in primary care settings1 community health centers1 jails1 and prisons2 7,f7 the number of individuals receiving treatment for opioid use disorder2 and 7,g7 additional indicators or metrics1 as appropriate1 such as metrics pertaining to specific populations1 including women and children1 ,american ,indians and ,alaskan ,natives1 individuals living in rural and non-urban areas1 and justice-involved populations1 that would further clarify the progress made in addressing the opioid misuse and abuse crisis4 7#b7 ,a reasonable goal1 such as a percentage decrease or other specified metric1 that signifies progress in meeting the goal described in subsection 7a71 and annual targets to help achieve that goal4 7c7 ,consideration of other substance use disorders ,in developing the national milestones under subsection 7b71 the ,secretary shall1 as appropriate1 consider other substance use disorders in addition to opioid use disorder4 7d7 ,extension of period ,if the ,secretary determines that the goal described in subsection 7a7 will not be achieved with respect to any indicator or metric established under subsection 7b77#b7 within #e years of the date of enactment of this ,act1 the ,secretary may extend the timeline for meeting such goal with respect to that indicator or metric4 ,the ,secretary shall include with any such extension a rationale for why additional time is needed and information on whether significant changes are needed in order to achieve such goal with respect to the indicator or metric4 7e7 ,annual status update ,not later than one year after the enactment of this ,act1 the ,secretary shall make available on the internet website of the ,department of ,health and ,human ,services1 and submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives1 an update on the progress1 including expected progress in the subsequent year1 in achieving the goals detailed in the national milestones4 ,each such update shall include the progress made in the first year or since the previous report1 as applicable1 in meeting each indicator or metric in the national milestones4 ,,ii ,finance #bjja4 ,short title ,this title may be cited as the ,helping to ,end ,addiction and ,lessen ,substance ,use ,disorders ,act of #bjah or the ,,heal ,act of #bjah4 ,a ,medicare #baja4 ,medicare opioid safety education 7a7 ,in general ,section #ahjd of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;b-#b7 is amended by adding at the end the following new subsection3 7d7 ,the notice provided under subsection 7a7 shall include-- 7#a7 references to educational resources regarding opioid use and pain management2 7#b7 a description of categories of alternative1 non-opioid pain management treatments covered under this title2 and 7#c7 a suggestion for the beneficiary to talk to a physician regarding opioid use and pain management4 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall apply to notices distributed prior to each ,medicare open enrollment period beginning after ,january #a1 #bjai4 #bajb4 ,expanding the use of telehealth services for the treatment of opioid use disorder and other substance use disorders 7a7 ,in general ,section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is amended-- 7#a7 in paragraph 7#b77;,b7-- 7,a7 in clause 7i71 in the matter preceding subclause 7,i71 by striking clause 7ii7 and inserting clause 7ii7 and paragraph 7#f77;,c72 and 7,b7 in clause 7ii71 in the heading1 by striking for home dialysis therapy2 7#b7 in paragraph 7#d77;,c7-- 7,a7 in clause 7i71 by striking paragraph 7#f7 and inserting paragraphs 7#e71 7#f71 and 7#g72 and 7,b7 in clause 7ii77,x71 by inserting or telehealth services described in paragraph 7#g7 before the period at the end2 and 7#c7 by adding at the end the following new paragraph3 7#g7 ,treatment of substance use disorder services furnished through telehealth ,the geographic requirements described in paragraph 7#d77;,c77i7 shall not apply with respect to telehealth services furnished on or after ,january #a1 #bjai1 to an eligible telehealth individual with a substance use disorder diagnosis for purposes of treatment of such disorder1 as determined by the ,secretary1 at an originating site described in paragraph 7#d77;,c77ii7 7other than an originating site described in subclause 7,,ix7 of such paragraph74 4 7b7 ,implementation ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 may implement the amendments made by this section by interim final rule4 7c7 ,report ,not later than #e years after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report on the impact of the implementation of the amendments made by this section with respect to telehealth services under section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 on-- 7#a7 the utilization of health care items and services under title ,,xviii of such ,act 7#db ,u4,s4,c4 #acie et seq47 related to substance use disorders1 including emergency department visits2 and 7#b7 health outcomes related to substance use disorders1 such as opioid overdose deaths4 #bajc4 ,comprehensive screenings for seniors 7a7 ,initial preventive physical examination ,section #ahfa7ww7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7ww77 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 by striking paragraph 7#b7 and and inserting paragraph 7#b712 and 7,b7 by inserting and the furnishing of a review of any current opioid prescriptions 7as defined in paragraph 7#d771 after #8#8upon the agreement with the individual102 and 7#b7 in paragraph 7#b7-- 7,a7 by redesignating subparagraph 7,n7 as subparagraph 7,o72 and 7,b7 by inserting after subparagraph 7,m7 the following new subparagraph3 7,n7 ,screening for potential substance use disorders4 2 and 7#c7 by adding at the end the following new paragraph3 7#d7 ,for purposes of paragraph 7#a71 the term a review of any current opioid prescriptions means1 with respect to an individual determined to have a current prescription for opioids-- 7,a7 a review of the potential risk factors to the individual for opioid use disorder2 7,b7 an evaluation of the individual's severity of pain and current treatment plan2 7,c7 the provision of information on non-opioid treatment options2 and 7,d7 a referral to a pain management specialist1 as appropriate4 4 7b7 ,annual wellness visit ,section #ahfa7;hhh77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7hhh77#b77 is amended-- 7#a7 by redesignating subparagraph 7,g7 as subparagraph 7,i72 and 7#b7 by inserting after subparagraph 7,f7 the following new subparagraphs3 7,g7 ,screening for potential substance use disorders and referral for treatment as appropriate4 7,h7 ,the furnishing of a review of any current opioid prescriptions 7as defined in subsection 7ww77#d774 4 7c7 ,effective date ,the amendments made by this section shall apply to examinations and visits furnished on or after ,january #a1 #bjai4 #bajd4 ,every prescription conveyed securely 7a7 ,in general ,section #ahfj;,d-#d7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;e77 is amended by adding at the end the following3 7#g7 ,requirement of e-prescribing for controlled substances 7,a7 ,in general ,subject to subparagraph 7,b71 a prescription for a covered part ,d drug under a prescription drug plan 7or under an ,,ma-,,pd plan7 for a schedule ,,ii1 ,,iii1 ,,iv1 or ,v controlled substance shall be transmitted by a health care practitioner electronically in accordance with an electronic prescription drug program that meets the requirements of paragraph 7#b74 7,b7 ,exception for certain circumstances ,the ,secretary shall1 through rulemaking1 specify circumstances and processes by which the ,secretary may waive the requirement under subparagraph 7,a71 with respect to a covered part ,d drug1 including in the case of-- 7i7 a prescription issued when the practitioner and dispensing pharmacy are the same entity2 7ii7 a prescription issued that cannot be transmitted electronically under the most recently implemented version of the ,national ,council for ,prescription ,drug ,programs ,,script ,standard2 7iii7 a prescription issued by a practitioner who received a waiver or a renewal thereof for a period of time as determined by the ,secretary1 not to exceed one year1 from the requirement to use electronic prescribing due to demonstrated economic hardship1 technological limitations that are not reasonably within the control of the practitioner1 or other exceptional circumstance demonstrated by the practitioner2 7iv7 a prescription issued by a practitioner under circumstances in which1 notwithstanding the practitioner's ability to submit a prescription electronically as required by this subsection1 such practitioner reasonably determines that it would be impractical for the individual involved to obtain substances prescribed by electronic prescription in a timely manner1 and such delay would adversely impact the individual's medical condition involved2 7v7 a prescription issued by a practitioner prescribing a drug under a research protocol2 7vi7 a prescription issued by a practitioner for a drug for which the ,food and ,drug ,administration requires a prescription to contain elements that are not able to be included in electronic prescribing such as1 a drug with risk evaluation and mitigation strategies that include elements to assure safe use2 7vii7 a prescription issued by a practitioner-- 7,i7 for an individual who receives hospice care under this title2 and 7,,ii7 that is not covered under the hospice benefit under this title2 and 7viii7 a prescription issued by a practitioner for an individual who is-- 7,i7 a resident of a nursing facility 7as defined in section #aiai7;a772 and 7,,ii7 dually eligible for benefits under this title and title ,,xix4 7,c7 ,dispensing 7i7 ,nothing in this paragraph shall be construed as requiring a sponsor of a prescription drug plan under this part1 ,,ma organization offering an ,,ma-,,pd plan under part ,c1 or a pharmacist to verify that a practitioner1 with respect to a prescription for a covered part ,d drug1 has a waiver 7or is otherwise exempt7 under subparagraph 7,b7 from the requirement under subparagraph 7,a74 7ii7 ,nothing in this paragraph shall be construed as affecting the ability of the plan to cover or the pharmacists' ability to continue to dispense covered part ,d drugs from otherwise valid written1 oral or fax prescriptions that are consistent with laws and regulations4 7iii7 ,nothing in this paragraph shall be construed as affecting the ability of an individual who is being prescribed a covered part ,d drug to designate a particular pharmacy to dispense the covered part ,d drug to the extent consistent with the requirements under subsection 7b77#a7 and under this paragraph4 7,d7 ,enforcement ,the ,secretary shall1 through rulemaking1 have authority to enforce and specify appropriate penalties for non-compliance with the requirement under subparagraph 7,a74 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall apply to coverage of drugs prescribed on or after ,january #a1 #bjba4 #baje4 ,standardizing electronic prior authorization for safe prescribing ,section #ahfj;,d-#d7;e77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;e77#b77 is amended by adding at the end the following new subparagraph3 7,e7 ,electronic prior authorization 7i7 ,in general ,not later than ,january #a1 #bjba1 the program shall provide for the secure electronic transmittal of-- 7,i7 a prior authorization request from the prescribing health care professional for coverage of a covered part ,d drug for a part ,d eligible individual enrolled in a part ,d plan 7as defined in section #ahfj;,d-#bc7;a77#e77 to the ,,pdp sponsor or ,medicare ,advantage organization offering such plan2 and 7,,ii7 a response1 in accordance with this subparagraph1 from such ,,pdp sponsor or ,medicare ,advantage organization1 respectively1 to such professional4 7ii7 ,electronic transmission 7,i7 ,exclusions ,for purposes of this subparagraph1 a facsimile1 a proprietary payer portal that does not meet standards specified by the ,secretary1 or an electronic form shall not be treated as an electronic transmission described in clause 7i74 7,,ii7 ,standards ,in order to be treated1 for purposes of this subparagraph1 as an electronic transmission described in clause 7i71 such transmission shall comply with technical standards adopted by the ,secretary in consultation with the ,national ,council for ,prescription ,drug ,programs1 other standard setting organizations determined appropriate by the ,secretary1 and stakeholders including ,,pdp sponsors1 ,medicare ,advantage organizations1 health care professionals1 and health information technology software vendors4 7,,iii7 ,application ,notwithstanding any other provision of law1 for purposes of this subparagraph1 the ,secretary may require the use of such standards adopted under subclause 7,,ii7 in lieu of any other applicable standards for an electronic transmission described in clause 7i7 for a covered part ,d drug for a part ,d eligible individual4 4 #bajf4 ,strengthening partnerships to prevent opioid abuse 7a7 ,in general ,section #ahei of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bh7 is amended by adding at the end the following new subsection3 7i7 ,program integrity transparency measures 7#a7 ,program integrity portal 7,a7 ,in general ,not later than #b years after the date of the enactment of this subsection1 the ,secretary shall1 after consultation with stakeholders1 establish a secure ,internet website portal that would allow a secure path for communication between the ,secretary1 ,,ma plans under this part1 prescription drug plans under part ,d1 and an eligible entity with a contract under section #ahic 7such as a ,medicare drug integrity contractor or any successor entity to a ,medicare drug integrity contractor71 in accordance with subsection 7j77#c7 of such section1 for the purpose of enabling through such portal-- 7i7 the referral by such plans of suspicious activities of a provider of services 7including a prescriber7 or supplier related to fraud1 waste1 and abuse for initiating or assisting investigations conducted by the eligible entity2 and 7ii7 data sharing among such ,,ma plans1 prescription drug plans1 and the ,secretary4 7,b7 ,required uses of portal ,the ,secretary shall disseminate the following information to ,,ma plans under this part and prescription drug plans under part ,d through the secure ,internet website portal established under subparagraph 7,a73 7i7 ,providers of services and suppliers that have been referred pursuant to subparagraph 7,a77i7 during the previous #ab-month period4 7ii7 ,providers of services and suppliers who are the subject of an active exclusion under section #aabh or who are subject to a suspension of payment under this title pursuant to section #ahfb7o7 or otherwise4 7iii7 ,providers of services and suppliers who are the subject of an active revocation of participation under this title1 including for not satisfying conditions of participation4 7iv7 ,in the case of such a plan that makes a referral under subparagraph 7,a77i7 through the portal with respect to suspicious activities of a provider of services 7including a prescriber7 or supplier1 if such provider 7or prescriber7 or supplier has been the subject of an administrative action under this title or title ,,xi with respect to similar activities1 a notification to such plan of such action so taken4 7,c7 ,rulemaking ,for purposes of this paragraph1 the ,secretary shall1 through rulemaking1 specify what constitutes suspicious activities related to fraud1 waste1 and abuse1 using guidance such as what is provided in the ,medicare ,program ,integrity ,manual #d4g4a4 7#b7 ,quarterly reports ,beginning not later than #b years after the date of the enactment of this subsection1 the ,secretary shall make available to ,,ma plans under this part and prescription drug plans under part ,d in a timely manner 7but no less frequently than quarterly7 and using information submitted to an entity described in paragraph 7#a7 through the portal described in such paragraph or pursuant to section #ahic1 information on fraud1 waste1 and abuse schemes and trends in identifying suspicious activity4 ,information included in each such report shall-- 7,a7 include administrative actions1 pertinent information related to opioid overprescribing1 and other data determined appropriate by the ,secretary in consultation with stakeholders2 and 7,b7 be anonymized information submitted by plans without identifying the source of such information4 7#c7 ,clarification ,nothing in this subsection shall preclude or otherwise affect referrals to the ,inspector ,general of the ,department of ,health and ,human ,services or other law enforcement entities4 4 7b7 ,contract requirement to communicate plan corrective actions against opioids over-prescribers ,section #aheg7;e77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bg7;e77#d77;,c77 is amended by adding at the end the following new paragraph3 7#e7 ,communicating plan corrective actions against opioids over-prescribers 7,a7 ,in general ,beginning with plan years beginning on or after ,january #a1 #bjba1 a contract under this section with an ,,ma organization shall require the organization to submit to the ,secretary1 through the process established under subparagraph 7,b71 information on credible evidence of suspicious activities of a provider of services 7including a prescriber7 or supplier related to fraud and other actions taken by such plans related to inappropriate prescribing of opioids4 7,b7 ,process ,not later than ,january #a1 #bjba1 the ,secretary shall1 in consultation with stakeholders1 establish a process under which ,,ma plans and prescription drug plans shall submit to the ,secretary information described in subparagraph 7,a74 7,c7 ,regulations ,for purposes of this paragraph1 including as applied under section #ahfj;,d-#ab7;b77#c77;,d71 the ,secretary shall1 pursuant to rulemaking-- 7i7 specify a definition for the term inappropriate prescribing of opioids and a method for determining if a provider of services prescribes such a high volume2 and 7ii7 establish the process described in subparagraph 7,b7 and the types of information that may be submitted through such process4 4 7c7 ,reference under part ,d to program integrity transparency measures ,section #ahfj;,d-#d of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7 is amended by adding at the end the following new subsection3 7m7 ,program integrity transparency measures ,for program integrity transparency measures applied with respect to prescription drug plan and ,,ma plans1 see section #ahei7;i74 4 #bajg4 ,commit to opioid medical prescriber accountability and safety for seniors ,section #ahfj;,d-#d7;c77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;c77#d77 is amended by adding at the end the following new subparagraph3 7,d7 ,notification and additional requirements with respect to statistical outlier prescribers of opioids 7i7 ,notification ,not later than ,january #a1 #bjba1 the ,secretary shall1 in the case of a prescriber identified by the ,secretary under clause 7ii7 to be a statistical outlier prescriber of opioids1 provide1 subject to clause 7iv71 an annual notification to such prescriber that such prescriber has been so identified that includes resources on proper prescribing methods and other information as specified in accordance with clause 7iii74 7ii7 ,identification of statistical outlier prescribers of opioids 7,i7 ,in general ,the ,secretary shall1 subject to subclause 7,,iii71 using the valid prescriber ,national ,provider ,identifiers included pursuant to subparagraph 7,a7 on claims for covered part ,d drugs for part ,d eligible individuals enrolled in prescription drug plans under this part or ,,ma-,,pd plans under part ,c and based on the thresholds established under subclause 7,,ii71 identify prescribers that are statistical outlier opioids prescribers for a period of time specified by the ,secretary4 7,,ii7 ,establishment of thresholds ,for purposes of subclause 7,i7 and subject to subclause 7,,iii71 the ,secretary shall1 after consultation with stakeholders1 establish thresholds1 based on prescriber specialty and1 as determined appropriate by the ,secretary1 geographic area1 for identifying whether a prescriber in a specialty and geographic area is a statistical outlier prescriber of opioids as compared to other prescribers of opioids within such specialty and area4 7,,iii7 ,exclusions ,the following shall not be included in the analysis for identifying statistical outlier prescribers of opioids under this clause3 7aa7 ,claims for covered part ,d drugs for part ,d eligible individuals who are receiving hospice care under this title4 7bb7 ,claims for covered part ,d drugs for part ,d eligible individuals who are receiving oncology services under this title4 7cc7 ,prescribers who are the subject of an investigation by the ,centers for ,medicare ,medicaid ,services or the ,inspector ,general of the ,department of ,health and ,human ,services4 7iii7 ,contents of notification ,the ,secretary shall include the following information in the notifications provided under clause 7i73 7,i7 ,information on how such prescriber compares to other prescribers within the same specialty and1 if determined appropriate by the ,secretary1 geographic area4 7,,ii7 ,information on opioid prescribing guidelines1 based on input from stakeholders1 that may include the ,centers for ,disease ,control and ,prevention guidelines for prescribing opioids for chronic pain and guidelines developed by physician organizations4 7,,iii7 ,other information determined appropriate by the ,secretary4 7iv7 ,modifications and expansions 7,i7 ,frequency ,beginning #e years after the date of the enactment of this subparagraph1 the ,secretary may change the frequency of the notifications described in clause 7i7 based on stakeholder input and changes in opioid prescribing utilization and trends4 7,,ii7 ,expansion to other prescriptions ,the ,secretary may expand notifications under this subparagraph to include identifications and notifications with respect to concurrent prescriptions of covered ,part ,d drugs used in combination with opioids that are considered to have adverse side effects when so used in such combination1 as determined by the ,secretary4 7v7 ,additional requirements for persistent statistical outlier prescribers ,in the case of a prescriber who the ,secretary determines is persistently identified under clause 7ii7 as a statistical outlier prescriber of opioids1 the following shall apply3 7,i7 ,the ,secretary shall provide an opportunity for such prescriber to receive technical assistance or educational resources on opioid prescribing guidelines 7such as the guidelines described in clause 7iii77,,ii77 from an entity that furnishes such assistance or resources1 which may include a quality improvement organization under part ,b of title ,,xi1 as available and appropriate4 7,,ii7 ,such prescriber may be required to enroll in the program under this title under section #ahff7;j7 if such prescriber is not otherwise required to enroll4 ,the ,secretary shall determine the length of the period for which such prescriber is required to maintain such enrollment4 7,,iii7 ,not less frequently than annually 7and in a form and manner determined appropriate by the ,secretary71 the ,secretary shall communicate information on such prescribers to sponsors of a prescription drug plan and ,medicare ,advantage organizations offering an ,,ma-,,pd plan4 7vi7 ,public availability of information ,the ,secretary shall make aggregate information under this subparagraph available on the ,internet website of the ,centers for ,medicare ,medicaid ,services4 ,such information shall be in a form and manner determined appropriate by the ,secretary and shall not identify any specific prescriber4 ,in carrying out this clause1 the ,secretary shall consult with interested stakeholders4 7vii7 ,opioids defined ,for purposes of this subparagraph1 the term opioids has such meaning as specified by the ,secretary4 7viii7 ,other activities ,nothing in this subparagraph shall preclude the ,secretary from conducting activities that provide prescribers with information as to how they compare to other prescribers that are in addition to the activities under this subparagraph1 including activities that were being conducted as of the date of the enactment of this subparagraph4 4 #bajh4 ,fighting the opioid epidemic with sunshine 7a7 ,inclusion of information regarding payments to advance practice nurses 7#a7 ,in general ,section #aabh;,g7e77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;h7e77#f77 is amended-- 7,a7 in subparagraph 7,a71 by adding at the end the following new clauses3 7iii7 ,a physician assistant1 nurse practitioner1 or clinical nurse specialist 7as such terms are defined in section #ahfa7;aa77#e774 7iv7 ,a certified registered nurse anesthetist 7as defined in section #ahfa7;bb77#b774 7v7 ,a certified nurse-midwife 7as defined in section #ahfa7;gg77#b774 2 and 7,b7 in subparagraph 7,b71 by inserting 1 physician assistant1 nurse practitioner1 clinical nurse specialist1 certified nurse anesthetist1 or certified nurse-midwife after physician4 7#b7 ,effective date ,the amendments made by this subsection shall apply with respect to information required to be submitted under section #aabh;,g of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;h7 on or after ,january #a1 #bjbb4 7b7 ,sunset of exclusion of ,national ,provider ,identifier of covered recipient in information made publicly available ,section #aabh;,g7c77#a77;,c77viii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;h7c77#a77;,c77viii777 is amended by striking does not contain and inserting in the case of information made available under this subparagraph prior to ,january #a1 #bjbb1 does not contain4 7c7 ,administration ,chapter #ce of title #dd1 ,united ,states ,code1 shall not apply to this section or the amendments made by this section4 #baji4 ,demonstration testing coverage of certain services furnished by opioid treatment programs ,title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 is amended by inserting after section #ahff;,e the following3 #ahff;,f4 ,demonstration testing coverage of certain services furnished by opioid treatment programs 7a7 ,establishment 7#a7 ,in general ,the ,secretary shall conduct a demonstration 7in this section referred to as the demonstration7 to test coverage of and payment for opioid use disorder treatment services 7as defined in paragraph 7#b77;,b77 furnished by opioid treatment programs 7as defined in paragraph 7#b77;,a77 to individuals under part ,b using a bundled payment as described in paragraph 7#c74 7#b7 ,definitions ,in this section3 7,a7 ,opioid treatment program ,the term opioid treatment program means an entity that is an opioid treatment program 7as defined in section #h4b of title #db of the ,code of ,federal ,regulations1 or any successor regulation7 that-- 7i7 is selected for participation in the demonstration2 7ii7 has in effect a certification by the ,substance ,abuse and ,mental ,health ,services ,administration for such a program2 7iii7 is accredited by an accrediting body approved by the ,substance ,abuse and ,mental ,health ,services ,administration2 7iv7 submits to the ,secretary data and information needed to monitor the quality of services furnished and conduct the evaluation described in subsection 7c72 and 7v7 meets such additional requirements as the ,secretary may find necessary4 7,b7 ,opioid use disorder treatment services ,the term opioid use disorder treatment services means items and services that are furnished by an opioid treatment program for the treatment of opioid use disorder1 including-- 7i7 opioid agonist and antagonist treatment medications 7including oral1 injected1 or implanted versions7 that are approved by the ,food and ,drug ,administration under section #eje of the ,federal ,food1 ,drug and ,cosmetic ,act for use in the treatment of opioid use disorder2 7ii7 dispensing and administration of such medications1 if applicable2 7iii7 substance use counseling by a professional to the extent authorized under ,state law to furnish such services2 7iv7 individual and group therapy with a physician or psychologist 7or other mental health professional to the extent authorized under ,state law72 7v7 toxicology testing2 and 7vi7 other items and services that the ,secretary determines are appropriate 7but in no case to include meals or transportation74 7#c7 ,bundled payment under part ,b 7,a7 ,in general ,the ,secretary shall pay1 from the ,federal ,supplementary ,medical ,insurance ,trust ,fund under section #ahda1 to an opioid treatment program participating in the demonstration a bundled payment as determined by the ,secretary for opioid use disorder treatment services that are furnished by such treatment program to an individual under part ,b during an episode of care 7as defined by the ,secretary74 7,b7 ,considerations ,the ,secretary may implement this paragraph through one or more bundles based on the type of medication provided 7such as buprenorphine1 methadone1 naltrexone1 or a new innovative drug71 the frequency of services furnished1 the scope of services furnished1 characteristics of the individuals furnished such services1 or other factors as the ,secretary determines appropriate4 ,in developing such bundles1 the ,secretary may consider payment rates paid to opioid treatment programs for comparable services under ,state plans under title ,,xix or under the ,,tricare program under chapter #ee of title #aj of the ,united ,states ,code4 7b7 ,implementation 7#a7 ,duration ,the demonstration shall be conducted for a period of #e years1 beginning not later than ,january #a1 #bjba4 7#b7 ,scope ,in carrying out the demonstration1 the ,secretary shall limit the number of beneficiaries that may participate at any one time in the demonstration to #b1jjj4 7#c7 ,waiver ,the ,secretary may waive such provisions of this title and title ,,xi as the ,secretary determines necessary in order to implement the demonstration4 7#d7 ,administration ,chapter #ce of title #dd1 ,united ,states ,code1 shall not apply to this section4 7c7 ,evaluation and report 7#a7 ,evaluation ,the ,secretary shall conduct an evaluation of the demonstration4 ,such evaluation shall include analyses of-- 7,a7 the impact of the demonstration on-- 7i7 utilization of health care items and services related to opioid use disorder1 including hospitalizations and emergency department visits2 7ii7 beneficiary health outcomes related to opioid use disorder1 including opioid overdose deaths2 and 7iii7 overall expenditures under this title2 and 7,b7 the performance of opioid treatment programs participating in the demonstration with respect to applicable quality and cost metrics1 including whether any additional quality measures related to opioid use disorder treatment are needed with respect to such programs under this title4 7#b7 ,report ,not later than #b years after the completion of the demonstration1 the ,secretary shall submit to ,congress a report containing the results of the evaluation conducted under paragraph 7#a71 together with recommendations for such legislation and administrative action as the ,secretary determines appropriate4 7d7 ,funding ,for purposes of administering and carrying out the demonstration1 in addition to funds otherwise appropriated1 there shall be transferred to the ,secretary for the ,center for ,medicare ,medicaid ,services ,program ,management ,account from the ,federal ,supplementary ,medical ,insurance ,trust ,fund under section #ahda #e1jjj1jjj1 to remain available until expended4 4 #baaj4 ,encouraging appropriate prescribing under ,medicare for victims of opioid overdose ,section #ahfj;,d-#d7;c77#e77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;c77#e77;,c77 is amended-- 7#a7 in clause 7i71 in the matter preceding subclause 7,i71 by striking ,for purposes and inserting ,except as provided in clause 7v71 for purposes2 and 7#b7 by adding at the end the following new clause3 7v7 ,treatment of enrollees with a history of opioid-related overdose 7,i7 ,in general ,for plan years beginning not later than ,january #a1 #bjba1 a part ,d eligible individual who is not an exempted individual described in clause 7ii7 and who is identified under this clause as a part ,d eligible individual with a history of opioid-related overdose 7as defined by the ,secretary7 shall be included as a potentially at-risk beneficiary for prescription drug abuse under the drug management program under this paragraph4 7,,ii7 ,identification and notice ,for purposes of this clause1 the ,secretary shall-- 7aa7 identify part ,d eligible individuals with a history of opioid-related overdose 7as so defined72 and 7bb7 notify the ,,pdp sponsor of the prescription drug plan in which such an individual is enrolled of such identification4 4 #baaa4 ,automatic escalation to external review under a ,medicare part ,d drug management program for at-risk beneficiaries 7a7 ,in general ,section #ahfj;,d-#d7;c77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww-#aj7;c77#e77 is amended-- 7#a7 in subparagraph 7,b71 in each of clauses 7ii77,,iii7 and 7iii77,,iv71 by striking and the option of an automatic escalation to external review and inserting 1 including notice that if on reconsideration a ,,pdp sponsor affirms its denial1 in whole or in part1 the case shall be automatically forwarded to the independent1 outside entity contracted with the ,secretary for review and resolution2 and 7#b7 in subparagraph 7,e71 by striking and the option and all that follows and inserting the following3 and if on reconsideration a ,,pdp sponsor affirms its denial1 in whole or in part1 the case shall be automatically forwarded to the independent1 outside entity contracted with the ,secretary for review and resolution44 7b7 ,effective date ,the amendments made by subsection 7a7 shall apply beginning not later ,january #a1 #bjba4 #baab4 ,testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology ,section #aaae;,a7b77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is amended by adding at the end the following new clause3 7xxv7 ,providing incentive payments to behavioral health providers for the adoption and use of certified electronic health record technology 7as defined in section #ahdh7o77#d77 to improve the quality and coordination of care through the electronic documentation and exchange of health information4 ,behavioral health providers may include-- 7,i7 psychiatric hospitals 7as defined in section #ahfa7;f772 7,,ii7 community mental health centers 7as defined in section #ahfa7;ff77#c77;,b772 7,,iii7 clinical psychologists 7as defined in section #ahfa7;ii772 7,,iv7 clinical social workers 7as defined in section #ahfa7;hh77#a772 and 7,v7 hospitals1 treatment facilities1 and mental health or substance use disorder providers that participate in a ,state plan under title ,,xix or a waiver of such plan4 4 #baac4 ,medicare ,improvement ,fund ,section #ahih7;b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;iii7b77#a77 is amended by striking fiscal year #bjba1 #j and inserting fiscal year #bjbd1 #fe1jjj1jjj4 ,b ,medicaid #bbja4 ,caring recovery for infants and babies 7a7 ,state plan amendment ,section #aijb7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77 is amended-- 7#a7 in paragraph 7#hb71 by striking and after the semicolon2 7#b7 in paragraph 7#hc71 by striking the period at the end and inserting 2 and2 and 7#c7 by inserting after paragraph 7#hc71 the following new paragraph3 7#hd7 provide1 at the option of the ,state1 for making medical assistance available on an inpatient or outpatient basis at a residential pediatric recovery center 7as defined in subsection 7nn77 to infants with neonatal abstinence syndrome4 4 7b7 ,residential pediatric recovery center defined ,section #aijb of such ,act 7#db ,u4,s4,c4 #acif;a7 is amended by adding at the end the following new subsection3 7nn7 ,residential pediatric recovery center defined 7#a7 ,in general ,for purposes of section #aijb7;a77#hd71 the term residential pediatric recovery center means a center or facility that furnishes items and services for which medical assistance is available under the ,state plan to infants with the diagnosis of neonatal abstinence syndrome without any other significant medical risk factors4 7#b7 ,counseling and services ,a residential pediatric recovery center may offer counseling and other services to mothers 7and other appropriate family members and caretakers7 of infants receiving treatment at such centers if such services are otherwise covered under the ,state plan under this title or under a waiver of such plan4 ,such other services may include the following3 7,a7 ,counseling or referrals for services4 7,b7 ,activities to encourage caregiver-infant bonding4 7,c7 ,training on caring for such infants4 4 7c7 ,effective date ,the amendments made by this section take effect on the date of enactment of this ,act and shall apply to medical assistance furnished on or after that date1 without regard to final regulations to carry out such amendments being promulgated as of such date4 #bbjb4 ,peer support enhancement and evaluation review 7a7 ,in general ,not later than #b years after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives1 the ,committee on ,finance of the ,senate1 and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate a report on the provision of peer support services under the ,medicaid program4 7b7 ,content of report 7#a7 ,in general ,the report required under subsection 7a7 shall include the following information3 7,a7 ,information on ,state coverage of peer support services under ,medicaid1 including-- 7i7 the mechanisms through which ,states may provide such coverage1 including through existing statutory authority or through waivers2 7ii7 the populations to which ,states have provided such coverage2 7iii7 the payment models1 including any alternative payment models1 used by ,states to pay providers of such services2 and 7iv7 where available1 information on ,federal and ,state spending under ,medicaid for peer support services4 7,b7 ,information on selected ,state experiences in providing medical assistance for peer support services under ,state ,medicaid plans and whether ,states measure the effects of providing such assistance with respect to-- 7i7 improving access to behavioral health services2 7ii7 improving early detection1 and preventing worsening1 of behavioral health disorders2 7iii7 reducing chronic and comorbid conditions2 and 7iv7 reducing overall health costs4 7#b7 ,recommendations ,the report required under subsection 7a7 shall include recommendations1 including recommendations for such legislative and administrative actions related to improving services1 including peer support services1 and access to peer support services under ,medicaid as the ,comptroller ,general of the ,united ,states determines appropriate4 #bbjc4 ,medicaid substance use disorder treatment via telehealth 7a7 ,definitions ,in this section3 7#a7 ,comptroller ,general ,the term ,comptroller ,general means the ,comptroller ,general of the ,united ,states4 7#b7 ,school-based health center ,the term school-based health center has the meaning given that term in section #baaj7;c77#i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;jj7c77#i774 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#d7 ,teleheath services ,the term telehealth services includes remote patient monitoring and other key modalities such as live video or synchronous telehealth1 store-and-forward or asynchronous telehealth1 mobile health1 telephonic consultation1 and electronic consult including provider-to-provider e-consults4 7#e7 ,underserved area ,the term underserved area means a health professional shortage area 7as defined in section #ccb7;a77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77#a77;,a777 and a medically underserved area 7according to a designation under section #ccj7;b77#c77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7b77#c77;,a7774 7b7 ,guidance to ,states regarding ,federal reimbursement for furnishing services and treatment for substance use disorders under ,medicaid using telehealth services1 including in school-based health centers ,not later than #a year after the date of enactment of this ,act1 the ,secretary1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall issue guidance to ,states on the following3 7#a7 ,state options for ,federal reimbursement of expenditures under ,medicaid for furnishing services and treatment for substance use disorders1 including assessment1 medication-assisted treatment1 counseling1 and medication management1 using telehealth services4 ,such guidance shall also include guidance on furnishing services and treatments that address the needs of high risk individuals1 including at least the following groups3 7,a7 ,american ,indians and ,alaska ,natives4 7,b7 ,adults under the age of #dj4 7,c7 ,individuals with a history of nonfatal overdose4 7#b7 ,state options for ,federal reimbursement of expenditures under ,medicaid for education directed to providers serving ,medicaid beneficiaries with substance use disorders using the hub and spoke model1 through contracts with managed care entities1 through administrative claiming for disease management activities1 and under ,delivery ,system ,reform ,incentive ,payment 7,,dsrip7 programs4 7#c7 ,state options for ,federal reimbursement of expenditures under ,medicaid for furnishing services and treatment for substance use disorders for individuals enrolled in ,medicaid in a school-based health center using telehealth services4 7c7 ,,gao evaluation of children's access to services and treatment for substance use disorders under ,medicaid 7#a7 ,study ,the ,comptroller ,general shall evaluate children's access to services and treatment for substance use disorders under ,medicaid4 ,the evaluation shall include an analysis of ,state options for improving children's access to such services and treatment and for improving outcomes1 including by increasing the number of ,medicaid providers who offer services or treatment for substance use disorders in a school-based health center using telehealth services1 particularly in rural and underserved areas4 ,the evaluation shall include an analysis of ,medicaid provider reimbursement rates for services and treatment for substance use disorders4 7#b7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general shall submit to ,congress a report containing the results of the evaluation conducted under paragraph 7#a71 together with recommendations for such legislation and administrative action as the ,comptroller ,general determines appropriate4 7d7 ,report on reducing barriers to using telehealth services and remote patient monitoring for pediatric populations under ,medicaid 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall issue a report to the ,committee on ,finance of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representative identifying best practices and potential solutions for reducing barriers to using telehealth services to furnish services and treatment for substance use disorders among pediatric populations under ,medicaid4 ,the report shall include-- 7,a7 analyses of the best practices1 barriers1 and potential solutions for using telehealth services to diagnose and provide services and treatment for children with substance use disorders1 including opioid use disorder2 and 7,b7 identification and analysis of the differences1 if any1 in furnishing services and treatment for children with substance use disorders using telehealth services and using services delivered in person1 such as1 and to the extent feasible1 with respect to-- 7i7 utilization rates2 7ii7 costs2 7iii7 avoidable inpatient admissions and readmissions2 7iv7 quality of care2 and 7v7 patient1 family1 and provider satisfaction4 7#b7 ,publication ,the ,secretary shall publish the report required under paragraph 7#a7 on a public ,internet website of the ,department of ,health and ,human ,services4 #bbjd4 ,enhancing patient access to non-opioid treatment options ,not later than ,january #a1 #bjai1 the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall issue #a or more final guidance documents1 or update existing guidance documents1 to ,states regarding mandatory and optional items and services that may be provided under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 or under a waiver of such a plan1 for non-opioid treatment and management of pain1 including1 but not limited to1 evidence-based non-opioid pharmacological therapies and non-pharmacological therapies4 #bbje4 ,assessing barriers to opioid use disorder treatment 7a7 ,study 7#a7 ,in general ,the ,comptroller ,general of the ,united ,states 7in this section referred to as the ,comptroller ,general7 shall conduct a study regarding the barriers to providing medication used in the treatment of substance use disorders under ,medicaid distribution models such as the buy-and-bill model1 and options for ,state ,medicaid programs to remove or reduce such barriers4 ,the study shall include analyses of each of the following models of distribution of substance use disorder treatment medications1 particularly buprenorphine1 naltrexone1 and buprenorphine-naloxone combinations3 7,a7 ,the purchasing1 storage1 and administration of substance use disorder treatment medications by providers4 7,b7 ,the dispensing of substance use disorder treatment medications by pharmacists4 7,c7 ,the ordering1 prescribing1 and obtaining substance use disorder treatment medications on demand from specialty pharmacies by providers4 7#b7 ,requirements ,for each model of distribution specified in paragraph 7#a71 the ,comptroller ,general shall evaluate how each model presents barriers or could be used by selected ,state ,medicaid programs to reduce the barriers related to the provision of substance use disorder treatment by examining what is known about the effects of the model of distribution on-- 7,a7 ,medicaid beneficiaries' access to substance use disorder treatment medications2 7,b7 the differential cost to the program between each distribution model for medication assisted treatment2 and 7,c7 provider willingness to provide or prescribe substance use disorder treatment medications4 7b7 ,report ,not later than #ae months after the date of the enactment of this ,act1 the ,comptroller ,general shall submit to ,congress a report containing the results of the study conducted under subsection 7a71 together with recommendations for such legislation and administrative action as the ,comptroller ,general determines appropriate4 #bbjf4 ,help for moms and babies 7a7 ,medicaid state plan ,section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is amended by adding at the end the following new sentence3 ,in the case of a woman who is eligible for medical assistance on the basis of being pregnant 7including through the end of the month in which the #fj-;day period beginning on the last day of her pregnancy ends71 who is a patient in an institution for mental diseases for purposes of receiving treatment for a substance use disorder1 and who was enrolled for medical assistance under the ,state plan immediately before becoming a patient in an institution for mental diseases or who becomes eligible to enroll for such medical assistance while such a patient1 the exclusion from the definition of medical assistance set forth in the subdivision 7,b7 following paragraph 7#bi7 of the first sentence of this subsection shall not be construed as prohibiting ,federal financial participation for medical assistance for items or services that are provided to the woman outside of the institution44 7b7 ,effective date 7#a7 ,in general ,except as provided in paragraph 7#b71 the amendment made by subsection 7a7 shall take effect on the date of enactment of this ,act4 7#b7 ,rule for changes requiring state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by the amendment made by subsection 7a71 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 #bbjg4 ,securing flexibility to treat substance use disorders ,section #aijc7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m77 is amended by adding at the end the following new paragraph3 7#g7 ,payment shall be made under this title to a ,state for expenditures for capitation payments described in section #dch4f7;e7 of title #db1 ,code of ,federal ,regulations 7or any successor regulation74 4 #bbjh4 ,,macpac study and report on ,,mat utilization controls under ,state ,medicaid programs 7a7 ,study ,the ,medicaid and ,,chip ,payment and ,access ,commission shall conduct a study and analysis of utilization control policies applied to medication-assisted treatment for substance use disorders under ,state ,medicaid programs1 including policies and procedures applied both in fee-for-service ,medicaid and in risk-based managed care ,medicaid1 which shall-- 7#a7 include an inventory of such utilization control policies and related protocols for ensuring access to medically necessary treatment2 7#b7 determine whether managed care utilization control policies and procedures for medication assisted treatment for substance use disorders are consistent with section #dch4baj7;a77#d77;ii7 of title #db1 ,code of ,federal ,regulations2 and 7#c7 identify policies that-- 7,a7 limit an individual's access to medication-assisted treatment for a substance use disorder by limiting the quantity of medication-assisted treatment prescriptions1 or the number of refills for such prescriptions1 available to the individual as part of a prior authorization process or similar utilization protocols2 and 7,b7 apply without evaluating individual instances of fraud1 waste1 or abuse4 7b7 ,report ,not later than #a year after the date of the enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission shall make publicly available a report containing the results of the study conducted under subsection 7a74 #bbji4 ,opioid addiction treatment programs enhancement 7a7 ,t-,,msis substance use disorder data book 7#a7 ,in general ,not later than the date that is #ab months after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall publish on the public website of the ,centers for ,medicare ,medicaid ,services a report with comprehensive data on the prevalence of substance use disorders in the ,medicaid beneficiary population and services provided for the treatment of substance use disorders under ,medicaid4 7#b7 ,content of report ,the report required under paragraph 7#a7 shall include1 at a minimum1 the following data for each ,state 7including1 to the extent available1 for the ,district of ,columbia1 ,puerto ,rico1 the ,virgin ,islands1 ,guam1 the ,northern ,mariana ,islands1 and ,american ,samoa73 7,a7 ,the number and percentage of individuals enrolled in the ,state ,medicaid plan or waiver of such plan in each of the major enrollment categories 7as defined in a public letter from the ,medicaid and ,,chip ,payment and ,access ,commission to the ,secretary7 who have been diagnosed with a substance use disorder and whether such individuals are enrolled under the ,state ,medicaid plan or a waiver of such plan1 including the specific waiver authority under which they are enrolled1 to the extent available4 7,b7 ,a list of the substance use disorder treatment services by each major type of service1 such as counseling1 medication assisted treatment1 peer support1 residential treatment1 and inpatient care1 for which beneficiaries in each ,state received at least #a service under the ,state ,medicaid plan or a waiver of such plan4 7,c7 ,the number and percentage of individuals with a substance use disorder diagnosis enrolled in the ,state ,medicaid plan or waiver of such plan who received substance use disorder treatment services under such plan or waiver by each major type of service under subparagraph 7,b7 within each major setting type1 such as outpatient1 inpatient1 residential1 and other home and community-based settings4 7,d7 ,the number of services provided under the ,state ,medicaid plan or waiver of such plan per individual with a substance use disorder diagnosis enrolled in such plan or waiver for each major type of service under subparagraph 7,b74 7,e7 ,the number and percentage of individuals enrolled in the ,state ,medicaid plan or waiver1 by major enrollment category1 who received substance use disorder treatment through-- 7i7 a medicaid managed care entity 7as defined in section #aicb7;a77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;a77#a77;,b7771 including the number of such individuals who received such assistance through a prepaid inpatient health plan or a prepaid ambulatory health plan2 7ii7 a fee-for-service payment model2 or 7iii7 an alternative payment model1 to the extent available4 7,f7 ,the number and percentage of individuals with a substance use disorder who receive substance use disorder treatment services in an outpatient or home and community-based setting after receiving treatment in an inpatient or residential setting1 and the number of services received by such individuals in the outpatient or home and community-based setting4 7#c7 ,annual updates ,the ,secretary shall issue an updated version of the report required under paragraph 7#a7 not later than ,january #a of each calendar year through #bjbd4 7#d7 ,use of ,t-,,msis data ,the report required under paragraph 7#a7 and updates required under paragraph 7#c7 shall-- 7,a7 use data and definitions from the ,transformed ,medicaid ,statistical ,information ,system 7,t-,,msis7 data set that is no more than #ab months old on the date that the report or update is published2 and 7,b7 as appropriate1 include a description with respect to each ,state of the quality and completeness of the data and caveats describing the limitations of the data reported to the ,secretary by the ,state that is sufficient to communicate the appropriate uses for the information4 7b7 ,making ,t-,,msis data on substance use disorders available to researchers 7#a7 ,in general ,the ,secretary shall publish in the ,federal ,register a system of records notice for the data specified in paragraph 7#b7 for the ,transformed ,medicaid ,statistical ,information ,system1 in accordance with section #eeb;a7e77#d7 of title #e1 ,united ,states ,code4 ,the notice shall outline policies that protect the security and privacy of the data that1 at a minimum1 meet the security and privacy policies of ,,sorn #ji-gj-jeda for the ,medicaid ,statistical ,information ,system4 7#b7 ,required data ,the data covered by the systems of records notice required under paragraph 7#a7 shall be sufficient for researchers and ,states to analyze the prevalence of substance use disorders in the ,medicaid beneficiary population and the treatment of substance use disorders under ,medicaid across all ,states 7including the ,district of ,columbia1 ,puerto ,rico1 the ,virgin ,islands1 ,guam1 the ,northern ,mariana ,islands1 and ,american ,samoa71 forms of treatment1 and treatment settings4 7#c7 ,initiation of data-sharing activities ,not later than ,january #a1 #bjai1 the ,secretary shall initiate the data-sharing activities outlined in the notice required under paragraph 7#a74 #bbaj4 ,better data sharing to combat the opioid crisis 7a7 ,in general ,section #aijc7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m771 as amended by section #bbjg1 is amended by adding at the end the following new paragraph3 7#h7 7,a7 ,the ,state agency administering the ,state plan under this title may have reasonable access1 as determined by the ,state1 to #a or more prescription drug monitoring program databases administered or accessed by the ,state to the extent the ,state agency is permitted to access such databases under ,state law4 7,b7 ,such ,state agency may facilitate reasonable access1 as determined by the ,state1 to #a or more prescription drug monitoring program databases administered or accessed by the ,state1 to same extent that the ,state agency is permitted under ,state law to access such databases1 for-- 7i7 any provider enrolled under the ,state plan to provide services to ,medicaid beneficiaries2 and 7ii7 any managed care entity 7as defined under section #aicb7;a77#a77;,b77 that has a contract with the ,state under this subsection or under section #aije7t77#c74 7,c7 ,such ,state agency may share information in such databases1 to the same extent that the ,state agency is permitted under ,state law to share information in such databases1 with-- 7i7 any provider enrolled under the ,state plan to provide services to ,medicaid beneficiaries2 and 7ii7 any managed care entity 7as defined under section #aicb7;a77#a77;,b77 that has a contract with the ,state under this subsection or under section #aije7t77#c74 4 7b7 ,security and privacy ,all applicable ,state and ,federal security and privacy protections and laws shall apply to any ,state agency1 individual1 or entity accessing #a or more prescription drug monitoring program databases or obtaining information in such databases in accordance with section #aijc7m77#h7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m77#h77 7as added by subsection 7a774 7c7 ,effective date ,the amendment made by subsection 7a7 shall take effect on the date of enactment of this ,act4 #bbaa4 ,mandatory reporting with respect to adult behavioral health measures ,section #aaci;,b of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;b7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#c7-- 7i7 by striking ,not later than ,january #a1 #bjac and inserting the following3 7,a7 ,voluntary reporting ,not later than ,january #a1 #bjac 2 and 7ii7 by adding at the end the following3 7,b7 ,mandatory reporting with respect to behavioral health measures ,beginning with the ,state report required under subsection 7d77#a7 for #bjbd1 the ,secretary shall require ,states to use all behavioral health measures included in the core set of adult health quality measures and any updates or changes to such measures to report information1 using the standardized format for reporting information and procedures developed under subparagraph 7,a71 regarding the quality of behavioral health care for ,medicaid eligible adults4 2 7,b7 in paragraph 7#e71 by adding at the end the following new subparagraph3 7,c7 ,behavioral health measures ,beginning with respect to ,state reports required under subsection 7d77#a7 for #bjbd1 the core set of adult health quality measures maintained under this paragraph 7and any updates or changes to such measures7 shall include behavioral health measures4 2 and 7#b7 in subsection 7d77#a77;,a7-- 7,a7 by striking the such plan and inserting such plan2 and 7,b7 by striking subsection 7a77#e7 and inserting subsection 7b77#e7 and1 beginning with the report for #bjbd1 all behavioral health measures included in the core set of adult health quality measures maintained under such subsection 7b77#e7 and any updates or changes to such measures 7as required under subsection 7b77#c774 #bbab4 ,report on innovative ,state initiatives and strategies to provide housing-related services and supports to individuals struggling with substance use disorders under ,medicaid 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall issue a report to ,congress describing innovative ,state initiatives and strategies for providing housing-related services and supports under a ,state ,medicaid program to individuals with substance use disorders who are experiencing or at risk of experiencing homelessness4 7b7 ,content of report ,the report required under subsection 7a7 shall describe the following3 7#a7 ,existing methods and innovative strategies developed and adopted by ,state ,medicaid programs that have achieved positive outcomes in increasing housing stability among ,medicaid beneficiaries with substance use disorders who are experiencing or at risk of experiencing homelessness1 including ,medicaid beneficiaries with substance use disorders who are-- 7,a7 receiving treatment for substance use disorders in inpatient1 residential1 outpatient1 or home and community-based settings2 7,b7 transitioning between substance use disorder treatment settings2 or 7,c7 living in supportive housing or another model of affordable housing4 7#b7 ,strategies employed by ,medicaid managed care organizations1 primary care case managers1 hospitals1 accountable care organizations1 and other care coordination providers to deliver housing-related services and supports and to coordinate services provided under ,state ,medicaid programs across different treatment settings4 7#c7 ,innovative strategies and lessons learned by ,states with ,medicaid waivers approved under section #aaae or #aiae of the ,social ,security ,act 7#db ,u4,s4,c4 #acae1 #acifn71 including-- 7,a7 challenges experienced by ,states in designing1 securing1 and implementing such waivers or plan amendments2 7,b7 how ,states developed partnerships with other organizations such as behavioral health agencies1 ,state housing agencies1 housing providers1 health care services agencies and providers1 community-based organizations1 and health insurance plans to implement waivers or ,state plan amendments2 and 7,c7 how and whether ,states plan to provide ,medicaid coverage for housing-related services and supports in the future1 including by covering such services and supports under ,state ,medicaid plans or waivers4 7#d7 ,existing opportunities for ,states to provide housing-related services and supports through a ,medicaid waiver under sections #aaae or #aiae of the ,social ,security ,act 7#db ,u4,s4,c4 #acae1 #acifn7 or through a ,state ,medicaid plan amendment1 such as the ,assistance in ,community ,integration ,service pilot program1 which promotes supportive housing and other housing-related supports under ,medicaid for individuals with substance use disorders and for which ,maryland has a waiver approved under such section #aaae to conduct the program4 7#e7 ,innovative strategies and partnerships developed and implemented by ,state ,medicaid programs or other entities to identify and enroll eligible individuals with substance use disorders who are experiencing or at risk of experiencing homelessness in ,state ,medicaid programs4 #bbac4 ,technical assistance and support for innovative ,state strategies to provide housing-related supports under ,medicaid 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall provide technical assistance and support to ,states regarding the development and expansion of innovative ,state strategies 7including through ,state ,medicaid demonstration projects7 to provide housing-related supports and services and care coordination services under ,medicaid to individuals with substance use disorders4 7b7 ,report ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall issue a report to ,congress detailing a plan of action to carry out the requirements of subsection 7a74 ,c ,human ,services #bcja4 ,supporting family-focused residential treatment 7a7 ,definitions ,in this section3 7#a7 ,family-focused residential treatment program ,the term family-focused residential treatment program means a trauma-informed residential program primarily for substance use disorder treatment for pregnant and postpartum women and parents and guardians that allows children to reside with such women or their parents or guardians during treatment to the extent appropriate and applicable4 7#b7 ,medicaid program ,the term ,medicaid program means the program established under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#d7 ,title ,,iv-,e program ,the term title ,,iv-,e program means the program for foster care1 prevention1 and permanency established under part ,e of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fgj et seq474 7b7 ,guidance on family-focused residential treatment programs 7#a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary1 in consultation with divisions of the ,department of ,health and ,human ,services administering substance use disorder or child welfare programs1 shall develop and issue guidance to ,states identifying opportunities to support family-focused residential treatment programs for the provision of substance use disorder treatment4 ,before issuing such guidance1 the ,secretary shall solicit input from representatives of ,states1 health care providers with expertise in addiction medicine1 obstetrics and gynecology1 neonatology1 child trauma1 and child development1 health plans1 recipients of family-focused treatment services1 and other relevant stakeholders4 7#b7 ,additional requirements ,the guidance required under paragraph 7#a7 shall include descriptions of the following3 7,a7 ,existing opportunities and flexibilities under the ,medicaid program1 including under waivers authorized under section #aaae or #aiae of the ,social ,security ,act 7#db ,u4,s4,c4 #acae1 #acifn71 for ,states to receive ,federal ,medicaid funding for the provision of substance use disorder treatment for pregnant and postpartum women and parents and guardians and1 to the extent applicable1 their children1 in family-focused residential treatment programs4 7,b7 ,how ,states can employ and coordinate funding provided under the ,medicaid program1 the title ,,iv-,e program1 and other programs administered by the ,secretary to support the provision of treatment and services provided by a family-focused residential treatment facility such as substance use disorder treatment and services1 including medication-assisted treatment1 family1 group1 and individual counseling1 case management1 parenting education and skills development1 the provision1 assessment1 or coordination of care and services for children1 including necessary assessments and appropriate interventions1 non-emergency transportation for necessary care provided at or away from a program site1 transitional services and supports for families leaving treatment1 and other services4 7,c7 ,how ,states can employ and coordinate funding provided under the ,medicaid program and the title ,,iv-,e program 7including as amended by the ,family ,first ,prevention ,services ,act enacted under title ,,vii of division ,e of ,public ,law #aae-abc1 and particularly with respect to the authority under subsections 7a77#b77;,c7 and 7j7 of section #dgb and section #dgd7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #fgb1 #fgd7;a77#a77 7as amended by section #ejgab of ,public ,law #aae-abc7 to provide foster care maintenance payments for a child placed with a parent who is receiving treatment in a licensed residential family-based treatment facility for a substance use disorder7 to support placing children with their parents in family-focused residential treatment programs4 #bcjb4 ,improving recovery and reunifying families 7a7 ,family ,recovery and ,reunification ,program ,replication ,project ,section #dce of the ,social ,security ,act 7#db ,u4,s4,c4 #fbi;e7 is amended by adding at the end the following3 7e7 ,family ,recovery and ,reunification ,program ,replication ,project 7#a7 ,purpose ,the purpose of this subsection is to provide resources to the ,secretary to support the conduct and evaluation of a family recovery and reunification program replication project 7referred to in this subsection as the project7 and to determine the extent to which such programs may be appropriate for use at different intervention points 7such as when a child is at risk of entering foster care or when a child is living with a guardian while a parent is in treatment74 ,the family recovery and reunification program conducted under the project shall use a recovery coach model that is designed to help reunify families and protect children by working with parents or guardians with a substance use disorder who have temporarily lost custody of their children4 7#b7 ,program components ,the family recovery and reunification program conducted under the project shall adhere closely to the elements and protocol determined to be most effective in other recovery coaching programs that have been rigorously evaluated and shown to increase family reunification and protect children and1 consistent with such elements and protocol1 shall provide such items and services as-- 7,a7 assessments to evaluate the needs of the parent or guardian2 7,b7 assistance in receiving the appropriate benefits to aid the parent or guardian in recovery2 7,c7 services to assist the parent or guardian in prioritizing issues identified in assessments1 establishing goals for resolving such issues that are consistent with the goals of the treatment provider1 child welfare agency1 courts1 and other agencies involved with the parent or guardian or their children1 and making a coordinated plan for achieving such goals2 7,d7 home visiting services coordinated with the child welfare agency and treatment provider involved with the parent or guardian or their children2 7,e7 case management services to remove barriers for the parent or guardian to participate and continue in treatment1 as well as to re-engage a parent or guardian who is not participating or progressing in treatment2 7,f7 access to services needed to monitor the parent's or guardian's compliance with program requirements2 7,g7 frequent reporting between the treatment provider1 child welfare agency1 courts1 and other agencies involved with the parent or guardian or their children to ensure appropriate information on the parent's or guardian's status is available to inform decision-making2 and 7,h7 assessments and recommendations provided by a recovery coach to the child welfare caseworker responsible for documenting the parent's or guardian's progress in treatment and recovery as well as the status of other areas identified in the treatment plan for the parent or guardian1 including a recommendation regarding the expected safety of the child if the child is returned to the custody of the parent or guardian that can be used by the caseworker and a court to make permanency decisions regarding the child4 7#c7 ,responsibilities of the secretary 7,a7 ,in general ,the ,secretary shall1 through a grant or contract with #a or more entities1 conduct and evaluate the family recovery and reunification program under the project4 7,b7 ,requirements ,in identifying #a or more entities to conduct the evaluation of the family recovery and reunification program1 the ,secretary shall-- 7i7 determine that the area or areas in which the program will be conducted have sufficient substance use disorder treatment providers and other resources 7other than those provided with funds made available to carry out the project7 to successfully conduct the program2 7ii7 determine that the area or areas in which the program will be conducted have enough potential program participants1 and will serve a sufficient number of parents or guardians and their children1 so as to allow for the formation of a control group1 evaluation results to be adequately powered1 and preliminary results of the evaluation to be available within #d years of the program's implementation2 7iii7 provide the entity or entities with technical assistance for the program design1 including by working with #a or more entities that are or have been involved in recovery coaching programs that have been rigorously evaluated and shown to increase family reunification and protect children so as to make sure the program conducted under the project adheres closely to the elements and protocol determined to be most effective in such other recovery coaching programs2 7iv7 assist the entity or entities in securing adequate coaching1 treatment1 child welfare1 court1 and other resources needed to successfully conduct the family recovery and reunification program under the project2 and 7v7 ensure the entity or entities will be able to monitor the impacts of the program in the area or areas in which it is conducted for at least #e years after parents or guardians and their children are randomly assigned to participate in the program or to be part of the program's control group4 7#d7 ,evaluation requirements 7,a7 ,in general ,the ,secretary1 in consultation with the entity or entities conducting the family recovery and reunification program under the project1 shall conduct an evaluation to determine whether the program has been implemented effectively and resulted in improvements for children and families4 ,the evaluation shall have #c components3 a pilot phase1 an impact study1 and an implementation study4 7,b7 ,pilot phase ,the pilot phase component of the evaluation shall consist of the ,secretary providing technical assistance to the entity or entities conducting the family recovery and reunification program under the project to ensure-- 7i7 the program's implementation adheres closely to the elements and protocol determined to be most effective in other recovery coaching programs that have been rigorously evaluated and shown to increase family reunification and protect children2 and 7ii7 random assignment of parents or guardians and their children to be participants in the program or to be part of the program's control group is being carried out4 7,c7 ,impact study ,the impact study component of the evaluation shall determine the impacts of the family recovery and reunification program conducted under the project on the parents and guardians and their children participating in the program4 ,the impact study component shall-- 7i7 be conducted using an experimental design that uses a random assignment research methodology2 7ii7 consistent with previous studies of other recovery coaching programs that have been rigorously evaluated and shown to increase family reunification and protect children1 measure outcomes for parents and guardians and their children over multiple time periods1 including for a period of #e years2 and 7iii7 include measurements of family stability and parent1 guardian1 and child safety for program participants and the program control group that are consistent with measurements of such factors for participants and control groups from previous studies of other recovery coaching programs so as to allow results of the impact study to be compared with the results of such prior studies1 including with respect to comparisons between program participants and the program control group regarding-- 7,i7 safe family reunification2 7,,ii7 time to reunification2 7,,iii7 permanency 7such as through measures of reunification1 adoption1 or placement with guardians72 7,,iv7 safety 7such as through measures of subsequent maltreatment72 7,v7 parental or guardian treatment persistence and engagement2 7,,vi7 parental or guardian substance use2 7,,vii7 juvenile delinquency2 7,,viii7 cost2 and 7,,ix7 other measurements agreed upon by the ,secretary and the entity or entities operating the family recovery and reunification program under the project4 7,d7 ,implementation study ,the implementation study component of the evaluation shall be conducted concurrently with the conduct of the impact study component and shall include1 in addition to such other information as the ,secretary may determine1 descriptions and analyses of-- 7i7 the adherence of the family recovery and reunification program conducted under the project to other recovery coaching programs that have been rigorously evaluated and shown to increase family reunification and protect children2 and 7ii7 the difference in services received or proposed to be received by the program participants and the program control group4 7,e7 ,report ,the ,secretary shall publish on an internet website maintained by the ,secretary the following information3 7i7 ,a report on the pilot phase component of the evaluation4 7ii7 ,a report on the impact study component of the evaluation4 7iii7 ,a report on the implementation study component of the evaluation4 7iv7 ,a report that includes-- 7,i7 analyses of the extent to which the program has resulted in increased reunifications1 increased permanency1 case closures1 net savings to the ,state or ,states involved 7taking into account both costs borne by ,states and the ,federal government71 or other outcomes1 or if the program did not produce such outcomes1 an analysis of why the replication of the program did not yield such results2 7,,ii7 if1 based on such analyses1 the ,secretary determines the program should be replicated1 a replication plan2 and 7,,iii7 such recommendations for legislation and administrative action as the ,secretary determines appropriate4 7#e7 ,appropriation ,in addition to any amounts otherwise made available to carry out this subpart1 out of any money in the ,treasury of the ,united ,states not otherwise appropriated1 there are appropriated #ae1jjj1jjj for fiscal year #bjai to carry out the project1 which shall remain available through fiscal year #bjbf4 4 7b7 ,clarification of payer of last resort application to child welfare prevention and family services ,section #dga7;e77#aj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #fga7;e77#aj771 as added by section #ejgaa7;a77#b7 of division ,e of ,public ,law #aae-abc1 is amended-- 7#a7 in subparagraph 7,a71 by inserting 1 nor shall the provision of such services or programs be construed to permit the ,state to reduce medical or other assistance available to a recipient of such services or programs after under this ,act2 and 7#b7 by adding at the end the following3 7,c7 ,payer of last resort ,in carrying out its responsibilities to ensure access to services or programs under this subsection1 the ,state agency shall not be considered to be a legally liable third party for purposes of satisfying a financial commitment for the cost of providing such services or programs with respect to any individual for whom such cost would have been paid for from another public or private source but for the enactment of this subsection 7except that whenever considered necessary to prevent a delay in the receipt of appropriate early intervention services by a child or family in a timely fashion1 funds provided under section #dgd7;a77#f7 may be used to pay the provider of services or programs pending reimbursement from the public or private source that has ultimate responsibility for the payment74 4 7c7 ,effective date ,the amendments made by subsection 7b7 shall take effect as if included in section #ejgaa of division ,e of ,public ,law #aae-abc4 #bcjc4 ,building capacity for family-focused residential treatment 7a7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means a ,state1 county1 local1 or tribal health or child welfare agency1 a private nonprofit organization1 a research organization1 a treatment service provider1 an institution of higher education 7as defined under section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja771 or another entity specified by the ,secretary4 7#b7 ,family-focused residential treatment program ,the term family-focused residential treatment program means a trauma-informed residential program primarily for substance use disorder treatment for pregnant and postpartum women and parents and guardians that allows children to reside with such women or their parents or guardians during treatment to the extent appropriate and applicable4 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7b7 ,support for the development of evidence-based family-focused residential treatment programs 7#a7 ,authority to award grants ,the ,secretary shall award grants to eligible entities for purposes of developing1 enhancing1 or evaluating family-focused residential treatment programs to increase the availability of such programs that meet the requirements for promising1 supported1 or well-supported practices specified in section #dga7;e77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #fga7;e77#d77;,c777 7as added by the ,family ,first ,prevention ,services ,act enacted under title ,,vii of division ,e of ,public ,law #aae-abc74 7#b7 ,evaluation requirement ,the ,secretary shall require any evaluation of a family-focused residential treatment program by an eligible entity that uses funds awarded under this section for all or part of the costs of the evaluation be designed to assist in the determination of whether the program may qualify as a promising1 supported1 or well-supported practice in accordance with the requirements of such section #dga7;e77#d77;,c74 7c7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary to carry out this section1 #bj1jjj1jjj for fiscal year #bjai1 which shall remain available through fiscal year #bjbc4 ,d ,synthetics ,trafficking and ,overdose ,prevention #bdja4 ,short title ,this subtitle may be cited as the ,synthetics ,trafficking and ,overdose ,prevention ,act of #bjah or ,,stop ,act of #bjah4 #bdjb4 ,customs fees 7a7 ,in general ,section #acjca7;b77#i7 of the ,consolidated ,omnibus ,budget ,reconciliation ,act of #aihe 7#ai ,u4,s4,c4 #eh;c7b77#i77 is amended by adding at the end the following3 7,d7 7i7 ,with respect to the processing of items that are sent to the ,united ,states through the international postal network by ,inbound ,express ,mail service or ,inbound ,,ems 7as that service is described in the mail classification schedule referred to in section #cfca of title #ci1 ,united ,states ,code71 the following payments are required3 7,i7 #a per ,inbound ,,ems item4 7,,ii7 ,if an ,inbound ,,ems item is formally entered1 the fee provided for under subsection 7a77#i71 if applicable4 7ii7 ,notwithstanding section #dea of the ,tariff ,act of #aicj 7#ai ,u4,s4,c4 #adea71 the payments required by clause 7i71 as allocated pursuant to clause 7iii77,i71 shall be the only payments required for reimbursement of ,u4,s4 ,customs and ,border ,protection for customs services provided in connection with the processing of an ,inbound ,,ems item4 7iii7 7,i7 ,the payments required by clause 7i77,i7 shall be allocated as follows3 7aa7 #ej percent of the amount of the payments shall be paid on a quarterly basis by the ,united ,states ,postal ,service to the ,commissioner of ,u4,s4 ,customs and ,border ,protection in accordance with regulations prescribed by the ,secretary of the ,treasury to reimburse ,u4,s4 ,customs and ,border ,protection for customs services provided in connection with the processing of ,inbound ,,ems items4 7bb7 #ej percent of the amount of the payments shall be retained by the ,postal ,service to reimburse the ,postal ,service for services provided in connection with the customs processing of ,inbound ,,ems items4 7,,ii7 ,payments received by ,u4,s4 ,customs and ,border ,protection under subclause 7,i77aa7 shall1 in accordance with section #ebd of the ,tariff ,act of #aicj 7#ai ,u4,s4,c4 #aebd71 be deposited in the ,customs ,user ,fee ,account and used to directly reimburse each appropriation for the amount paid out of that appropriation for the costs incurred in providing services to international mail facilities4 ,amounts deposited in accordance with the preceding sentence shall be available until expended for the provision of such services4 7,,iii7 ,payments retained by the ,postal ,service under subclause 7,i77bb7 shall be used to directly reimburse the ,postal ,service for the costs incurred in providing services in connection with the customs processing of ,inbound ,,ems items4 7iv7 ,beginning in fiscal year #bjba1 the ,secretary1 in consultation with the ,postmaster ,general1 may adjust1 not more frequently than once each fiscal year1 the amount described in clause 7i77,i7 to an amount commensurate with the costs of services provided in connection with the customs processing of ,inbound ,,ems items1 consistent with the obligations of the ,united ,states under international agreements4 4 7b7 ,conforming amendments ,section #acjca7;a7 of the ,consolidated ,omnibus ,budget ,reconciliation ,act of #aihe 7#ai ,u4,s4,c4 #eh;c7a77 is amended-- 7#a7 in paragraph 7#f71 by inserting 7other than an item subject to a fee under subsection 7b77#i77;,d77 after customs officer2 and 7#b7 in paragraph 7#aj7-- 7,a7 in subparagraph 7,c71 in the matter preceding clause 7i71 by inserting 7other than ,inbound ,,ems items described in subsection 7b77#i77;,d77 after release2 and 7,b7 in the flush at the end1 by inserting or of ,inbound ,,ems items described in subsection 7b77#i77;,d71 after 7,c714 7c7 ,effective date ,the amendments made by this section shall take effect on ,january #a1 #bjbj4 #bdjc4 ,mandatory advance electronic information for postal shipments 7a7 ,mandatory advance electronic information 7#a7 ,in general ,section #cdc7;a77#c77,k7 of the ,trade ,act of #bjjb 7,public ,law #ajg-baj2 #ai ,u4,s4,c4 #bjga note7 is amended to read as follows3 7,k7 7i7 ,the ,secretary shall prescribe regulations requiring the ,united ,states ,postal ,service to transmit the information described in paragraphs 7#a7 and 7#b7 to the ,commissioner of ,u4,s4 ,customs and ,border ,protection for international mail shipments by the ,postal ,service 7including shipments to the ,postal ,service from foreign postal operators that are transported by private carrier7 consistent with the requirements of this subparagraph4 7ii7 ,in prescribing regulations under clause 7i71 the ,secretary shall impose requirements for the transmission to the ,commissioner of information described in paragraphs 7#a7 and 7#b7 for mail shipments described in clause 7i7 that are comparable to the requirements for the transmission of such information imposed on similar non-mail shipments of cargo1 taking into account the parameters set forth in subparagraphs 7,a7 through 7,j74 7iii7 ,the regulations prescribed under clause 7i7 shall require the transmission of the information described in paragraphs 7#a7 and 7#b7 with respect to a shipment as soon as practicable in relation to the transportation of the shipment1 consistent with subparagraph 7,h74 7iv7 ,regulations prescribed under clause 7i7 shall allow for the requirements for the transmission to the ,commissioner of information described in paragraphs 7#a7 and 7#b7 for mail shipments described in clause 7i7 to be implemented in phases1 as appropriate1 by-- 7,i7 setting incremental targets for increasing the percentage of such shipments for which information is required to be transmitted to the ,commissioner2 and 7,,ii7 taking into consideration-- 7aa7 the risk posed by such shipments2 7bb7 the volume of mail shipped to the ,united ,states by or through a particular country2 and 7cc7 the capacities of foreign postal operators to provide that information to the ,postal ,service4 7v7 7,i7 ,notwithstanding clause 7iv71 the ,postal ,service shall1 not later than ,december #ca1 #bjah1 arrange for the transmission to the ,commissioner of the information described in paragraphs 7#a7 and 7#b7 for not less than #gj percent of the aggregate number of mail shipments1 including #ajj percent of mail shipments from the ,people's ,republic of ,china1 described in clause 7i74 7,,ii7 ,if the requirements of subclause 7,i7 are not met1 the ,comptroller ,general of the ,united ,states shall submit to the appropriate congressional committees1 not later than ,june #cj1 #bjai1 a report-- 7aa7 assessing the reasons for the failure to meet those requirements2 and 7bb7 identifying recommendations to improve the collection by the ,postal ,service of the information described in paragraphs 7#a7 and 7#b74 7vi7 7,i7 ,notwithstanding clause 7iv71 the ,postal ,service shall1 not later than ,december #ca1 #bjbj1 arrange for the transmission to the ,commissioner of the information described in paragraphs 7#a7 and 7#b7 for #ajj percent of the aggregate number of mail shipments described in clause 7i74 7,,ii7 ,the ,commissioner1 in consultation with the ,postmaster ,general1 may determine to exclude a country from the requirement described in subclause 7,i7 to transmit information for mail shipments described in clause 7i7 from the country if the ,commissioner determines that the country-- 7aa7 does not have the capacity to collect and transmit such information2 7bb7 represents a low risk for mail shipments that violate relevant ,united ,states laws and regulations2 and 7cc7 accounts for low volumes of mail shipments that can be effectively screened for compliance with relevant ,united ,states laws and regulations through an alternate means4 7,,iii7 ,the ,commissioner shall1 at a minimum on an annual basis1 re-evaluate any determination made under subclause 7,,ii7 to exclude a country from the requirement described in subclause 7,i74 ,if1 at any time1 the ,commissioner determines that a country no longer meets the requirements under subclause 7,,ii71 the ,commissioner may not further exclude the country from the requirement described in subclause 7,i74 7,,iv7 ,the ,commissioner shall1 on an annual basis1 submit to the appropriate congressional committees-- 7aa7 a list of countries with respect to which the ,commissioner has made a determination under subclause 7,,ii7 to exclude the countries from the requirement described in subclause 7,i72 and 7bb7 information used to support such determination with respect to such countries4 7vii7 7,i7 ,the ,postmaster ,general shall1 in consultation with the ,commissioner1 refuse any shipments received after ,december #ca1 #bjbj1 for which the information described in paragraphs 7#a7 and 7#b7 is not transmitted as required under this subparagraph1 except as provided in subclause 7,,ii74 7,,ii7 ,if remedial action is warranted in lieu of refusal of shipments pursuant to subclause 7,i71 the ,postmaster ,general and the ,commissioner shall take remedial action with respect to the shipments1 including destruction1 seizure1 controlled delivery or other law enforcement initiatives1 or correction of the failure to provide the information described in paragraphs 7#a7 and 7#b7 with respect to the shipment4 7viii7 ,nothing in this subparagraph shall be construed to limit the authority of the ,secretary to obtain information relating to international mail shipments from private carriers or other appropriate parties4 7ix7 ,in this subparagraph1 the term appropriate congressional committees means-- 7,i7 the ,committee on ,finance and the ,committee on ,homeland ,security and ,governmental ,affairs of the ,senate2 and 7,,ii7 the ,committee on ,ways and ,means1 the ,committee on ,oversight and ,government ,reform1 and the ,committee on ,homeland ,security of the ,house of ,representatives4 4 7#b7 ,joint strategic plan on mandatory advance information ,not later than #fj days after the date of the enactment of this ,act1 the ,secretary of ,homeland ,security and the ,postmaster ,general shall develop and submit to the appropriate congressional committees a joint strategic plan detailing specific performance measures for achieving-- 7,a7 the transmission of information as required by section #cdc7;a77#c77,k7 of the ,trade ,act of #bjjb1 as amended by paragraph 7#a72 and 7,b7 the presentation by the ,postal ,service to ,u4,s4 ,customs and ,border ,protection of all mail targeted by ,u4,s4 ,customs and ,border ,protection for inspection4 7b7 ,capacity building 7#a7 ,in general ,section #cdc7;a7 of the ,trade ,act of #bjjb 7,public ,law #ajg-baj2 #ai ,u4,s4,c4 #bjga note7 is amended by adding at the end the following3 7#e7 ,capacity building 7,a7 ,in general ,the ,secretary1 with the concurrence of the ,secretary of ,state1 and in coordination with the ,postmaster ,general and the heads of other ,federal agencies1 as appropriate1 may provide technical assistance1 equipment1 technology1 and training to enhance the capacity of foreign postal operators-- 7i7 to gather and provide the information required by paragraph 7#c77,k72 and 7ii7 to otherwise gather and provide postal shipment information related to-- 7,i7 terrorism2 7,,ii7 items the importation or introduction of which into the ,united ,states is prohibited or restricted1 including controlled substances2 and 7,,iii7 such other concerns as the ,secretary determines appropriate4 7,b7 ,provision of equipment and technology ,with respect to the provision of equipment and technology under subparagraph 7,a71 the ,secretary may lease1 loan1 provide1 or otherwise assist in the deployment of such equipment and technology under such terms and conditions as the ,secretary may prescribe1 including nonreimbursable loans or the transfer of ownership of equipment and technology4 4 7#b7 ,joint strategic plan on capacity building ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,homeland ,security and the ,postmaster ,general shall1 in consultation with the ,secretary of ,state1 jointly develop and submit to the appropriate congressional committees a joint strategic plan-- 7,a7 detailing the extent to which ,u4,s4 ,customs and ,border ,protection and the ,united ,states ,postal ,service are engaged in capacity building efforts under section #cdc7;a77#e7 of the ,trade ,act of #bjjb1 as added by paragraph 7#a72 7,b7 describing plans for future capacity building efforts2 and 7,c7 assessing how capacity building has increased the ability of ,u4,s4 ,customs and ,border ,protection and the ,postal ,service to advance the goals of this subtitle and the amendments made by this subtitle4 7c7 ,report and consultations by ,secretary of ,homeland ,security and ,postmaster ,general 7#a7 ,report ,not later than #ahj days after the date of the enactment of this ,act1 and annually thereafter until #c years after the ,postmaster ,general has met the requirement under clause 7vi7 of subparagraph 7,k7 of section #cdc7;a77#c7 of the ,trade ,act of #bjjb1 as amended by subsection 7a77#a71 the ,secretary of ,homeland ,security and the ,postmaster ,general shall1 in consultation with the ,secretary of ,state1 jointly submit to the appropriate congressional committees a report on compliance with that subparagraph that includes the following3 7,a7 ,an assessment of the status of the regulations required to be promulgated under that subparagraph4 7,b7 ,an update regarding new and existing agreements reached with foreign postal operators for the transmission of the information required by that subparagraph4 7,c7 ,a summary of deliberations between the ,united ,states ,postal ,service and foreign postal operators with respect to issues relating to the transmission of that information4 7,d7 ,a summary of the progress made in achieving the transmission of that information for the percentage of shipments required by that subparagraph4 7,e7 ,an assessment of the quality of that information being received by foreign postal operators1 as determined by the ,secretary of ,homeland ,security1 and actions taken to improve the quality of that information4 7,f7 ,a summary of policies established by the ,universal ,postal ,union that may affect the ability of the ,postmaster ,general to obtain the transmission of that information4 7,g7 ,a summary of the use of technology to detect illicit synthetic opioids and other illegal substances in international mail parcels and planned acquisitions and advancements in such technology4 7,h7 ,such other information as the ,secretary of ,homeland ,security and the ,postmaster ,general consider appropriate with respect to obtaining the transmission of information required by that subparagraph4 7#b7 ,consultations ,not later than #ahj days after the date of the enactment of this ,act1 and every #ahj days thereafter until the ,postmaster ,general has met the requirement under clause 7vi7 of section #cdc7;a77#c77,k7 of the ,trade ,act of #bjjb1 as amended by subsection 7a77#a71 to arrange for the transmission of information with respect to #ajj percent of the aggregate number of mail shipments described in clause 7i7 of that section1 the ,secretary of ,homeland ,security and the ,postmaster ,general shall provide briefings to the appropriate congressional committees on the progress made in achieving the transmission of that information for that percentage of shipments4 7d7 ,government ,accountability ,office report ,not later than ,june #cj1 #bjai1 the ,comptroller ,general of the ,united ,states shall submit to the appropriate congressional committees a report-- 7#a7 assessing the progress of the ,united ,states ,postal ,service in achieving the transmission of the information required by subparagraph 7,k7 of section #cdc7;a77#c7 of the ,trade ,act of #bjjb1 as amended by subsection 7a77#a71 for the percentage of shipments required by that subparagraph2 7#b7 assessing the quality of the information received from foreign postal operators for targeting purposes2 7#c7 assessing the specific percentage of targeted mail presented by the ,postal ,service to ,u4,s4 ,customs and ,border ,protection for inspection2 7#d7 describing the costs of collecting the information required by such subparagraph 7,k7 from foreign postal operators and the costs of implementing the use of that information2 7#e7 assessing the benefits of receiving that information with respect to international mail shipments2 7#f7 assessing the feasibility of assessing a customs fee under section #acjca7;b77#i7 of the ,consolidated ,omnibus ,budget ,reconciliation ,act of #aihe1 as amended by section #bdjb1 on international mail shipments other than ,inbound ,express ,mail service in a manner consistent with the obligations of the ,united ,states under international agreements2 and 7#g7 identifying recommendations1 including recommendations for legislation1 to improve the compliance of the ,postal ,service with such subparagraph 7,k71 including an assessment of whether the detection of illicit synthetic opioids in the international mail would be improved by-- 7,a7 requiring the ,postal ,service to serve as the consignee for international mail shipments containing goods2 or 7,b7 designating a customs broker to act as an importer of record for international mail shipments containing goods4 7e7 ,technical correction ,section #cdc of the ,trade ,act of #bjjb 7,public ,law #ajg-baj2 #ai ,u4,s4,c4 #bjga note7 is amended in the section heading by striking advanced and inserting advance4 7f7 ,appropriate congressional committees defined ,in this section1 the term appropriate congressional committees means-- 7#a7 the ,committee on ,finance and the ,committee on ,homeland ,security and ,governmental ,affairs of the ,senate2 and 7#b7 the ,committee on ,ways and ,means1 the ,committee on ,oversight and ,government ,reform1 and the ,committee on ,homeland ,security of the ,house of ,representatives4 #bdjd4 ,international postal agreements 7a7 ,existing agreements 7#a7 ,in general ,in the event that any provision of this subtitle1 or any amendment made by this subtitle1 is determined to be in violation of obligations of the ,united ,states under any postal treaty1 convention1 or other international agreement related to international postal services1 or any amendment to such an agreement1 the ,secretary of ,state should negotiate to amend the relevant provisions of the agreement so that the ,united ,states is no longer in violation of the agreement4 7#b7 ,rule of construction ,nothing in this subsection shall be construed to permit delay in the implementation of this subtitle or any amendment made by this subtitle4 7b7 ,future agreements 7#a7 ,consultations ,before entering into1 on or after the date of the enactment of this ,act1 any postal treaty1 convention1 or other international agreement related to international postal services1 or any amendment to such an agreement1 that is related to the ability of the ,united ,states to secure the provision of advance electronic information by foreign postal operators1 the ,secretary of ,state should consult with the appropriate congressional committees 7as defined in section #bdjc7;f774 7#b7 ,expedited negotiation of new agreement ,to the extent that any new postal treaty1 convention1 or other international agreement related to international postal services would improve the ability of the ,united ,states to secure the provision of advance electronic information by foreign postal operators as required by regulations prescribed under section #cdc7;a77#c77,k7 of the ,trade ,act of #bjjb1 as amended by section #bdjc7;a77#a71 the ,secretary of ,state should expeditiously conclude such an agreement4 #bdje4 ,cost recoupment 7a7 ,in general ,the ,united ,states ,postal ,service shall1 to the extent practicable and otherwise recoverable by law1 ensure that all costs associated with complying with this subtitle and amendments made by this subtitle are charged directly to foreign shippers or foreign postal operators4 7b7 ,costs not considered revenue ,the recovery of costs under subsection 7a7 shall not be deemed revenue for purposes of subchapter ,i and ,,ii of chapter #cf of title #ci1 ,united ,states ,code1 or regulations prescribed under that chapter4 #bdjf4 ,development of technology to detect illicit narcotics 7a7 ,in general ,the ,postmaster ,general and the ,commissioner of ,u4,s4 ,customs and ,border ,protection1 in coordination with the heads of other agencies as appropriate1 shall collaborate to identify and develop technology for the detection of illicit fentanyl1 other synthetic opioids1 and other narcotics and psychoactive substances entering the ,united ,states by mail4 7b7 ,outreach to private sector ,the ,postmaster ,general and the ,commissioner shall conduct outreach to private sector entities to gather information regarding the current state of technology to identify areas for innovation relating to the detection of illicit fentanyl1 other synthetic opioids1 and other narcotics and psychoactive substances entering the ,united ,states4 #bdjg4 ,civil penalties for postal shipments ,section #dcf of the ,tariff ,act of #aicj 7#ai ,u4,s4,c4 #adcf7 is amended by adding at the end the following new subsection3 7e7 ,civil penalties for postal shipments 7#a7 ,civil penalty ,a civil penalty shall be imposed against the ,united ,states ,postal ,service if the ,postal ,service accepts a shipment in violation of section #cdc7;a77#c77,k77vii77,i7 of the ,trade ,act of #bjjb4 7#b7 ,modification of civil penalty 7,a7 ,in general ,u4,s4 ,customs and ,border ,protection shall reduce or dismiss a civil penalty imposed pursuant to paragraph 7#a7 if ,u4,s4 ,customs and ,border ,protection determines that the ,united ,states ,postal ,service-- 7i7 has a low error rate in compliance with section #cdc7;a77#c77,k7 of the ,trade ,act of #bjjb2 7ii7 is cooperating with ,u4,s4 ,customs and ,border ,protection with respect to the violation of section #cdc7;a77#c77,k77vii77,i7 of the ,trade ,act of #bjjb2 or 7iii7 has taken remedial action to prevent future violations of section #cdc7;a77#c77,k77vii77,i7 of the ,trade ,act of #bjjb4 7,b7 ,written notification ,u4,s4 ,customs and ,border ,protection shall issue a written notification to the ,postal ,service with respect to each exercise of the authority of subparagraph 7,a7 to reduce or dismiss a civil penalty imposed pursuant to paragraph 7#a74 7#c7 ,ongoing lack of compliance ,if ,u4,s4 ,customs and ,border ,protection determines that the ,united ,states ,postal ,service-- 7,a7 has repeatedly committed violations of section #cdc7;a77#c77,k77vii77,i7 of the ,trade ,act of #bjjb1 7,b7 has failed to cooperate with ,u4,s4 ,customs and ,border ,protection with respect to violations of section #cdc7;a77#c77,k77vii77,i7 of the ,trade ,act of #bjjb1 and 7,c7 has an increasing error rate in compliance with section #cdc7;a77#c77,k7 of the ,trade ,act of #bjjb1 civil penalties may be imposed against the ,united ,states ,postal ,service until corrective action1 satisfactory to ,u4,s4 ,customs and ,border ,protection1 is taken4 4 #bdjh4 ,report on violations of arrival1 reporting1 entry1 and clearance requirements and falsity or lack of manifest 7a7 ,in general ,the ,commissioner of ,u4,s4 ,customs and ,border ,protection shall submit to the appropriate congressional committees an annual report that contains the information described in subsection 7b7 with respect to each violation of section #dcf of the ,tariff ,act of #aicj 7#ai ,u4,s4,c4 #adcf71 as amended by section #g1 and section #ehd of such ,act 7#ai ,u4,s4,c4 #aehd7 that occurred during the previous year4 7b7 ,information described ,the information described in this subsection is the following3 7#a7 ,the name and address of the violator4 7#b7 ,the specific violation that was committed4 7#c7 ,the location or port of entry through which the items were transported4 7#d7 ,an inventory of the items seized1 including a description of the items and the quantity seized4 7#e7 ,the location from which the items originated4 7#f7 ,the entity responsible for the apprehension or seizure1 organized by location or port of entry4 7#g7 ,the amount of penalties assessed by ,u4,s4 ,customs and ,border ,protection1 organized by name of the violator and location or port of entry4 7#h7 ,the amount of penalties that ,u4,s4 ,customs and ,border ,protection could have levied1 organized by name of the violator and location or port of entry4 7#i7 ,the rationale for negotiating lower penalties1 organized by name of the violator and location or port of entry4 7c7 ,appropriate congressional committees defined ,in this section1 the term appropriate congressional committees means-- 7#a7 the ,committee on ,finance and the ,committee on ,homeland ,security and ,governmental ,affairs of the ,senate2 and 7#b7 the ,committee on ,ways and ,means1 the ,committee on ,oversight and ,government ,reform1 and the ,committee on ,homeland ,security of the ,house of ,representatives4 #bdji4 ,effective date2 regulations 7a7 ,effective date ,this subtitle and the amendments made by this subtitle 7other than the amendments made by section #bdjb7 shall take effect on the date of the enactment of this ,act4 7b7 ,regulations ,not later than one year after the date of the enactment of this ,act1 such regulations as are necessary to carry out this subtitle and the amendments made by this subtitle shall be prescribed4 ,,iii ,judiciary ,a ,access to ,increased ,drug ,disposal #caja4 ,short title ,this subtitle may be cited as the ,access to ,increased ,drug ,disposal ,act of #bjah4 #cajb4 ,definitions ,in this subtitle-- 7#a7 the term ,attorney ,general means the ,attorney ,general1 acting through the ,assistant ,attorney ,general for the ,office of ,justice ,programs2 7#b7 the term authorized collector means a narcotic treatment program1 a hospital or clinic with an on-site pharmacy1 a retail pharmacy1 or a reverse distributor1 that is authorized as a collector under section #acag4dj of title #ba1 ,code of ,federal ,regulations 7or any successor regulation72 7#c7 the term covered grant means a grant awarded under section #cjjc2 and 7#d7 the term eligible collector means a person who is eligible to be an authorized collector4 #cajc4 ,authority to make grants ,the ,attorney ,general shall award grants to ,states to enable the ,states to increase the participation of eligible collectors as authorized collectors4 #cajd4 ,application ,a ,state desiring a covered grant shall submit to the ,attorney ,general an application that1 at a minimum-- 7#a7 identifies the single ,state agency that oversees pharmaceutical care and will be responsible for complying with the requirements of the grant2 7#b7 details a plan to increase participation rates of eligible collectors as authorized collectors2 and 7#c7 describes how the ,state will select eligible collectors to be served under the grant4 #caje4 ,use of grant funds ,a ,state that receives a covered grant1 and any subrecipient of the grant1 may use the grant amounts only for the costs of installation1 maintenance1 training1 purchasing1 and disposal of controlled substances associated with the participation of eligible collectors as authorized collectors4 #cajf4 ,eligibility for grant ,the ,attorney ,general shall award a covered grant to #e ,states1 not less than #c of which shall be ,states in the lowest quartile of ,states based on the participation rate of eligible collectors as authorized collectors1 as determined by the ,attorney ,general4 #cajg4 ,duration of grants ,the ,attorney ,general shall determine the period of years for which a covered grant is made to a ,state4 #cajh4 ,accountability and oversight ,a ,state that receives a covered grant shall submit to the ,attorney ,general a report1 at such time and in such manner as the ,attorney ,general may reasonably require1 that-- 7#a7 lists the ultimate recipients of the grant amounts2 7#b7 describes the activities undertaken by the ,state using the grant amounts2 and 7#c7 contains performance measures relating to the effectiveness of the grant1 including changes in the participation rate of eligible collectors as authorized collectors4 #caji4 ,duration of program ,the ,attorney ,general may award covered grants for each of the first #e fiscal years beginning after the date of enactment of this ,act4 #caaj4 ,authorization of appropriations ,there is authorized to be appropriated to the ,attorney ,general such sums as may be necessary to carry out this subtitle4 ,b ,using ,data ,to ,prevent ,opioid ,diversion #cbja4 ,short title ,this subtitle may be cited as the ,using ,data to ,prevent ,opioid ,diversion ,act of #bjah4 #cbjb4 ,purpose 7a7 ,in general ,the purpose of this subtitle is to provide drug manufacturers and distributors with access to anonymized information through the ,automated ,reports and ,consolidated ,orders ,system to help drug manufacturers and distributors identify1 report1 and stop suspicious orders of opioids and reduce diversion rates4 7b7 ,rule of construction ,nothing in this subtitle should be construed to absolve a drug manufacturer1 drug distributor1 or other ,drug ,enforcement ,administration registrant from the responsibility of the manufacturer1 distributor1 or other registrant to-- 7#a7 identify1 stop1 and report suspicious orders2 or 7#b7 maintain effective controls against diversion in accordance with section #cjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7 or any successor law or associated regulation4 #cbjc4 ,amendments 7a7 ,records and reports of registrants ,section #cjg of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbg7 is amended-- 7#a7 by redesignating subsections 7f71 7g71 and 7h7 as subsections 7g71 7h71 and 7i71 respectively2 7#b7 by inserting after subsection 7e7 the following3 7f7 7#a7 ,the ,attorney ,general shall1 not less frequently than quarterly1 make the following information available to manufacturer and distributor registrants through the ,automated ,reports and ,consolidated ,orders ,system1 or any subsequent automated system developed by the ,drug ,enforcement ,administration to monitor selected controlled substances3 7,a7 ,the total number of distributor registrants that distribute controlled substances to a pharmacy or practitioner registrant1 aggregated by the name and address of each pharmacy and practitioner registrant4 7,b7 ,the total quantity and type of opioids distributed1 listed by ,administration ,controlled ,substances ,code ,number1 to each pharmacy and practitioner registrant described in subparagraph 7,a74 7#b7 ,the information required to be made available under paragraph 7#a7 shall be made available not later than the #aeth day of the first month following the quarter to which the information relates4 7#c7 7,a7 ,all registered manufacturers and distributors shall be responsible for reviewing the information made available by the ,attorney ,general under this subsection4 7,b7 ,in determining whether to initiate proceedings under this title against a registered manufacturer or distributor based on the failure of the registrant to maintain effective controls against diversion or otherwise comply with the requirements of this title or the regulations issued thereunder1 the ,attorney ,general may take into account that the information made available under this subsection was available to the registrant4 2 and 7#c7 by inserting after subsection 7i71 as so redesignated1 the following3 7j7 ,all of the reports required under this section shall be provided in an electronic format4 4 7b7 ,cooperative arrangements ,section #ejc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hgc7 is amended-- 7#a7 by striking subsection 7c7 and inserting the following3 7c7 7#a7 ,the ,attorney ,general shall1 once every #f months1 prepare and make available to regulatory1 licensing1 attorneys general1 and law enforcement agencies of ,states a standardized report containing descriptive and analytic information on the actual distribution patterns1 as gathered through the ,automated ,reports and ,consolidated ,orders ,system1 or any subsequent automated system1 pursuant to section #cjg and which includes detailed amounts1 outliers1 and trends of distributor and pharmacy registrants1 in such ,states for the controlled substances contained in schedule ,,ii1 which1 in the discretion of the ,attorney ,general1 are determined to have the highest abuse4 7#b7 ,if the ,attorney ,general publishes the report described in paragraph 7#a7 once every #f months as required under paragraph 7#a71 nothing in this subsection shall be construed to bring an action in any court to challenge the sufficiency of the information or to compel the ,attorney ,general to produce any documents or reports referred to in this subsection4 4 7c7 ,civil and criminal penalties ,section #djb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hdb7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#ae71 by striking or at the end2 7,b7 in paragraph 7#af71 by striking the period at the end and inserting 2 or2 and 7,c7 by inserting after paragraph 7#af7 the following3 7#ag7 in the case of a registered manufacturer or distributor of opioids1 to fail to review the most recent information1 directly related to the customers of the manufacturer or distributor1 made available by the ,attorney ,general in accordance with section #cjg7;f74 2 and 7#b7 in subsection 7c7-- 7,a7 in paragraph 7#a71 by striking subparagraph 7,b7 and inserting the following3 7,b7 7i7 ,except as provided in clause 7ii71 in the case of a violation of paragraph 7#e71 7#aj71 or 7#ag7 of subsection 7a71 the penalty shall not exceed #aj1jjj4 7ii7 ,in the case of a violation described in clause 7i7 committed by a registered manufacturer or distributor of opioids and related to the reporting of suspicious orders for opioids1 failing to maintain effective controls against diversion of opioids1 or failing to review the most recent information made available by the ,attorney ,general in accordance with section #cjg7;f71 the penalty shall not exceed #ajj1jjj4 2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,a71 by inserting or 7,d7 after subparagraph 7,b72 and 7ii7 by adding at the end the following3 7,d7 ,in the case of a violation described in subparagraph 7,a7 that was a violation of paragraph 7#e71 7#aj71 or 7#ag7 of subsection 7a7 committed by a registered manufacturer or distributor of opioids that relates to the reporting of suspicious orders for opioids1 failing to maintain effective controls against diversion of opioids1 or failing to review the most recent information made available by the ,attorney ,general in accordance with section #cjg7;f71 the criminal fine under title #ah1 ,united ,states ,code1 shall not exceed #ejj1jjj4 4 #cbjd4 ,report ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall submit to ,congress a report that provides information about how the ,attorney ,general is using data in the ,automation of ,reports and ,consolidated ,orders ,system to identify and stop suspicious activity1 including whether the ,attorney ,general is looking at aggregate orders from individual pharmacies to multiple distributors that in total are suspicious1 even if no individual order rises to the level of a suspicious order to a given distributor4 ,c ,substance ,abuse ,prevention #ccja4 ,short title ,this subtitle may be cited as the ,substance ,abuse ,prevention ,act of #bjah4 #ccjb4 ,reauthorization of the ,office of ,national ,drug ,control ,policy 7a7 ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#a7 ,in general ,the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agja et seq471 as in effect on ,september #bi1 #bjjc1 and as amended by the laws described in paragraph 7#b71 is revived and restored4 7#b7 ,laws described ,the laws described in this paragraph are3 7,a7 ,the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #bjjf 7,public ,law #aji-dfi2 #abj ,stat4 #cejb74 7,b7 ,the ,presidential ,appointment ,efficiency and ,streamlining ,act of #bjaa 7,public ,law #aab-aff2 #abf ,stat4 #abhc74 7b7 ,reauthorization ,section #gae7;a7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agab7;a77 is amended by striking #bjaj and inserting #bjbb4 #ccjc4 ,reauthorization of the ,drug-,free ,communities ,program ,section #ajbd of the ,national ,narcotics ,leadership ,act of #aihh 7#ba ,u4,s4,c4 #aebd7;a77 is amended by striking subsections 7a7 and 7b7 and inserting the following3 7a7 ,in general ,there is authorized to be appropriated to the ,office of ,national ,drug ,control ,policy to carry out this chapter #ii1jjj1jjj for each of fiscal years #bjah through #bjbb4 7b7 ,administrative costs ,not more than #h percent of the funds appropriated to carry out this chapter may be used by the ,office of ,national ,drug ,control ,policy to pay administrative costs associated with the responsibilities of the ,office under this chapter4 4 #ccjd4 ,reauthorization of the ,national ,community ,anti-,drug ,coalition ,institute ,section #d7;c77#d7 of ,public ,law #ajg-hb 7#ba ,u4,s4,c4 #aeba note7 is amended by striking #bjjh through #bjab and inserting #bjah through #bjbb4 #ccje4 ,reauthorization of the ,high-,intensity ,drug ,trafficking ,area ,program ,section #gjg7p7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjf7p77 is amended-- 7#a7 in paragraph 7#d71 by striking and at the end2 7#b7 in paragraph 7#e71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#f7 #bhj1jjj1jjj for each of fiscal years #bjah through #bjbb4 4 #ccjf4 ,reauthorization of drug court program ,section #ajja7;a77#be77;,a7 of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajbfa7;a77#be77;,a77 is amended by striking ,except as provided and all that follows and inserting the following3 ,except as provided in subparagraph 7,c71 there is authorized to be appropriated to carry out part ,,ee #ge1jjj1jjj for each of fiscal years #bjah through #bjbb44 #ccjg4 ,drug court training and technical assistance ,section #gje of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjd7 is amended by adding at the end the following-- 7e7 ,drug ,court ,training and ,technical ,assistance ,program ,using funds appropriated to carry out this title1 the ,director may make grants to nonprofit organizations for the purpose of providing training and technical assistance to drug courts4 4 #ccjh4 ,drug overdose response strategy ,section #gjg of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjf7 is amended by adding at the end the following3 7r7 ,drug overdose response strategy implementation ,the ,director may use funds appropriated to carry out this section to implement a drug overdose response strategy in high intensity drug trafficking areas on a nationwide basis by-- 7#a7 coordinating multi-disciplinary efforts to prevent1 reduce1 and respond to drug overdoses1 including the uniform reporting of fatal and non-fatal overdoses to public health and safety officials2 7#b7 increasing data sharing among public safety and public health officials concerning drug-related abuse trends1 including new psychoactive substances1 and related crime2 and 7#c7 enabling collaborative deployment of prevention1 intervention1 and enforcement resources to address substance use addiction and narcotics trafficking4 4 #ccji4 ,protecting law enforcement officers from accidental exposure ,section #gjg of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjf71 as amended by section #ccjh1 is amended by adding at the end the following3 7s7 ,supplemental grants ,the ,director is authorized to use not more than #aj1jjj1jjj of the amounts otherwise appropriated to carry out this section to provide supplemental competitive grants to high intensity drug trafficking areas that have experienced high seizures of fentanyl and new psychoactive substances for the purposes of-- 7#a7 purchasing portable equipment to test for fentanyl and other substances2 7#b7 training law enforcement officers and other first responders on best practices for handling fentanyl and other substances2 and 7#c7 purchasing protective equipment1 including overdose reversal drugs4 4 #ccaj4 ,,cops ,anti-,meth ,program ,section #agja of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajcha7 is amended-- 7#a7 by redesignating subsection 7k7 as subsection 7l72 and 7#b7 by inserting after subsection 7j7 the following3 7k7 ,,cops ,anti-,meth ,program ,the ,attorney ,general shall use amounts otherwise appropriated to carry out this section to make competitive grants1 in amounts of not less than #a1jjj1jjj for a fiscal year1 to ,state law enforcement agencies with high seizures of precursor chemicals1 finished methamphetamine1 laboratories1 and laboratory dump seizures for the purpose of locating or investigating illicit activities1 such as precursor diversion1 laboratories1 or methamphetamine traffickers4 4 #ccaa4 ,,cops anti-heroin task force program ,section #agja of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajcha7 is amended-- 7#a7 by redesignating subsection 7l71 as so redesignated by section #ccaj1 as subsection 7m72 and 7#b7 by inserting after subsection 7k71 as added by section #ccaj1 the following3 7l7 ,cops anti-heroin task force program ,the ,attorney ,general shall use amounts otherwise appropriated to carry out this section1 or other amounts as appropriated1 to make competitive grants to ,state law enforcement agencies in ,states with high per capita rates of primary treatment admissions1 for the purpose of locating or investigating illicit activities1 through ,statewide collaboration1 relating to the distribution of heroin1 fentanyl1 or carfentanil or relating to the unlawful distribution of prescription opioids4 4 #ccab4 ,comprehensive ,addiction and ,recovery ,act education and awareness ,title ,,vii of the ,comprehensive ,addiction and ,recovery ,act of #bjaf 7,public ,law #aad-aih2 #acj ,stat4 #gce7 is amended by adding at the end the following3 #gji4 ,services for families and patients in crisis 7a7 ,in general ,the ,attorney ,general may make grants to entities that focus on addiction and substance use disorders and specialize in family and patient services1 advocacy for patients and families1 and educational information4 7b7 ,allowable uses ,a grant awarded under this section may be used for private1 nonprofit national organizations that engage in all of the following activities3 7#a7 ,expansion of phone line or call center services with professional1 clinical staff that provide1 for families and individuals impacted by a substance use disorder1 support1 access to treatment resources1 brief assessments1 medication and overdose prevention education1 compassionate listening services1 recovery support or peer specialists1 bereavement and grief support1 and case management4 7#b7 ,continued development of health information technology systems that leverage new and upcoming technology and techniques for prevention1 intervention1 and filling resource gaps in communities that are underserved4 7#c7 ,enhancement and operation of treatment and recovery resources1 easy-to-read scientific and evidence-based education on addiction and substance use disorders1 and other informational tools for families and individuals impacted by a substance use disorder and community stakeholders1 such as law enforcement agencies4 7#d7 ,provision of training and technical assistance to ,state and local governments1 law enforcement agencies1 health care systems1 research institutions1 and other stakeholders4 7#e7 ,expanding upon and implementing educational information using evidence-based information on substance use disorders4 7#f7 ,expansion of training of community stakeholders1 law enforcement officers1 and families across a broad-range of addiction1 health1 and related topics on substance use disorders1 local issues and community-specific issues related to the drug epidemic4 7#g7 ,program evaluation4 7c7 ,authorization of appropriations ,for each of fiscal years #bjah through #bjbb1 the ,attorney ,general is authorized to award not more than #aj1jjj1jjj of amounts otherwise appropriated to the ,attorney ,general for comprehensive opioid abuse reduction activities for purposes of carrying out this section4 4 #ccac4 ,protecting children with addicted parents ,part ,d of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd et seq47 is amended by adding at the end the following3 #eej4 ,protecting children with addicted parents 7a7 ,best practices ,the ,secretary1 acting through the ,assistant ,secretary and in cooperation with the ,commissioner of the ,administration on ,children1 ,youth and ,families1 shall collect and disseminate best practices for ,states regarding interventions and strategies to keep families affected by a substance use disorder together1 when it can be done safely4 ,such best practices shall-- 7#a7 utilize comprehensive family-centered approaches2 7#b7 ensure that families have access to drug screening1 substance use disorder treatment1 medication-assisted treatment approved by the ,food and ,drug ,administration1 and parental support2 and 7#c7 build upon lessons learned from-- 7,a7 programs such as the maternal1 infant1 and early childhood home visiting program under section #eaa of the ,social ,security ,act2 and 7,b7 identifying substance abuse prevention and treatment services that meet the requirements for promising1 supported1 or well-supported practices specified in section #dga7;e77#d77;,c7 of the ,social ,security ,act 7as such section shall be in effect beginning on ,october #a1 #bjah74 7b7 ,grant program ,the ,secretary shall award grants to ,states1 units of local government1 and tribal governments to-- 7#a7 develop programs and models designed to keep pregnant and post-partum women who have a substance use disorder together with their newborns1 including programs and models that provide for screenings of pregnant and post-partum women for substance use disorders1 treatment interventions1 supportive housing1 nonpharmacological interventions for children born with neonatal abstinence syndrome1 medication assisted treatment1 and other recovery supports2 and 7#b7 support the attendance of children who have a family member living with a substance use disorder at therapeutic camps or other therapeutic programs aimed at addiction prevention education and delaying the onset of first use1 providing trusted mentors and education on coping strategies that these children can use in their daily lives1 and family support initiatives aimed at keeping these families together4 4 #ccad4 ,reimbursement of substance use disorder treatment professionals ,not later than ,january #a1 #bjbj1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report examining how substance use disorder services are reimbursed4 #ccae4 ,sobriety ,treatment and ,recovery ,teams 7,,start7 ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd et seq471 as amended by section #ccac1 is further amended by adding at the end the following3 #eea4 ,sobriety ,treatment and ,recovery ,teams 7a7 ,in general ,the ,secretary may make grants to ,states1 units of local government1 or tribal governments to establish or expand ,sobriety ,treatment ,and ,recovery ,team 7referred to in this section as ,,start7 or other similar programs to determine the effectiveness of pairing social workers or mentors with families that are struggling with a substance use disorder and child abuse or neglect in order to help provide peer support1 intensive treatment1 and child welfare services to such families4 7b7 ,allowable uses ,a grant awarded under this section may be used for one or more of the following activities3 7#a7 ,training eligible staff1 including social workers1 social services coordinators1 child welfare specialists1 substance use disorder treatment professionals1 and mentors4 7#b7 ,expanding access to substance use disorder treatment services and drug testing4 7#c7 ,enhancing data sharing with law enforcement agencies1 child welfare agencies1 substance use disorder treatment providers1 judges1 and court personnel4 7#d7 ,program evaluation and technical assistance4 7c7 ,program requirements ,a ,state1 unit of local government1 or tribal government receiving a grant under this section shall-- 7#a7 serve only families for which-- 7,a7 there is an open record with the child welfare agency2 and 7,b7 substance use disorder was a reason for the record or finding described in paragraph 7#a72 and 7#b7 coordinate any grants awarded under this section with any grant awarded under section #dcg7;f7 of the ,social ,security ,act focused on improving outcomes for children affected by substance abuse4 7d7 ,technical assistance ,the ,secretary may reserve not more than #e percent of funds provided under this section to provide technical assistance on the establishment or expansion of programs funded under this section from the ,national ,center on ,substance ,abuse and ,child ,welfare4 7e7 ,authorization of appropriations ,for each of fiscal years #bjah through #bjbb1 the ,secretary is authorized to award not more than #aj1jjj1jjj of amounts otherwise appropriated to the ,secretary for comprehensive opioid abuse reduction activities for purposes of carrying out this section4 4 #ccaf4 ,provider education ,not later than #fj days after the date of enactment of this ,act1 the ,attorney ,general1 in consultation with the ,secretary of ,health and ,human ,services1 shall complete the plan related to medical registration coordination required by ,senate ,report #aad-bci1 which accompanied the ,veterans ,care ,financial ,protection ,act of #bjag 7,public ,law #aae-aca2 #acb ,stat4 #ccd74 #ccag4 ,demand reduction ,section #gjb7a7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agja7a77 is amended-- 7#a7 by redesignating subparagraphs 7,f7 through 7,j7 as subparagraphs 7,g7 through 7,k71 respectively2 and 7#b7 by inserting after subparagraph 7,e7 the following3 7,f7 support for long-term recovery from substance use disorders2 4 #ccah4 ,anti-drug media campaign ,section #gji of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjh7 is amended-- 7#a7 in the section heading1 by striking youth2 7#b7 in subsection 7a7-- 7,a7 in the matter preceding paragraph 7#a71 by striking youth2 7,b7 in paragraph 7#a71 by striking young2 7,c7 in paragraph 7#b71 by striking of adults of the impact of drug abuse on young people and inserting among the population about the impact of drug abuse2 and 7,d7 in paragraph 7#c71 by striking parents and other interested adults to discuss with young people and inserting interested persons to discuss2 and 7#c7 in subsection 7b77#b77;,c77ii71 by striking among youth4 #ccai4 ,technical corrections to the office of national drug control policy reauthorization act of #aiih ,the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agja et seq47 is amended-- 7#a7 in section #gjc7;b77#c77;,e7 7#ba ,u4,s4,c4 #agjb7;b77#c77;,e77-- 7,a7 in clause 7i71 by adding and at the end2 7,b7 in clause 7ii71 by striking 2 and and inserting a period2 and 7,c7 by striking clause 7iii72 7#b7 in section #gjd 7#ba ,u4,s4,c4 #agjc7-- 7,a7 in subsection 7c77#c77;,c7-- 7i7 in clause 7v71 by adding and at the end2 7ii7 in clause 7vi71 by striking 2 and and inserting a period2 and 7iii7 by striking clause 7vii72 and 7,b7 in subsection 7f7-- 7i7 by striking the first paragraph 7#e72 and 7ii7 by striking the second paragraph 7#d72 7#c7 in section #gjf7;a77#b77;,a7 7#ba ,u4,s4,c4 #agje7;a77#b77;,a77-- 7,a7 by striking clause 7ix72 and 7,b7 by redesignating clauses 7x7 through 7xiv7 as clauses 7ix7 through 7xiii71 respectively2 and 7#d7 by striking section #gjh 7#ba ,u4,s4,c4 #agjg74 ,d ,synthetic ,abuse and ,labeling of ,toxic ,substances #cdja4 ,short title ,this subtitle may be cited as the ,synthetic ,abuse and ,labeling of ,toxic ,substances ,act of #bjag or the ,,salts ,act4 #cdjb4 ,controlled substance analogues ,section #bjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hac7 is amended-- 7#a7 by striking ,a controlled and inserting 7a7 ,in general4--,a controlled2 and 7#b7 by adding at the end the following3 7b7 ,determination ,in determining whether a controlled substance analogue was intended for human consumption under subsection 7a71 evidence related to the following factors may be considered1 along with all other relevant evidence3 7#a7 ,the marketing1 advertising1 and labeling of the substance4 7#b7 ,the known efficacy or usefulness of the substance for the marketed1 advertised1 or labeled purpose4 7#c7 ,the difference between the price at which the substance is sold and the price at which the substance it is purported to be or advertised as is normally sold4 7#d7 ,the diversion of the substance from legitimate channels and the clandestine importation1 manufacture1 or distribution of the substance4 7#e7 ,whether the defendant knew or should have known the substance was intended to be consumed by injection1 inhalation1 ingestion1 or any other immediate means4 7c7 ,limitation ,for purposes of this section1 the existence of evidence that a substance was not marketed1 advertised1 or labeled for human consumption shall not preclude the ,government from establishing1 based on all the evidence1 that the substance was intended for human consumption4 4 ,e ,opioid ,quota ,reform #ceja4 ,short title ,this subtitle may be cited as the ,opioid ,quota ,reform ,act4 #cejb4 ,strengthening considerations for ,,dea opioid quotas 7a7 ,in general ,section #cjf of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbf7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by inserting 7#a7 after 7a72 7,b7 in the second sentence1 by striking ,production and inserting ,except as provided in paragraph 7#b71 production2 and 7,c7 by adding at the end the following3 7#b7 ,the ,attorney ,general may1 if the ,attorney ,general determines it will assist in avoiding the overproduction1 shortages1 or diversion of a controlled substance1 establish an aggregate or individual production quota under this subsection1 or a procurement quota established by the ,attorney ,general by regulation1 in terms of pharmaceutical dosage forms prepared from or containing the controlled substance4 2 7#b7 in subsection 7b71 in the first sentence1 by striking production and inserting manufacturing2 7#c7 in subsection 7c71 by striking ,october and inserting ,december2 and 7#d7 by adding at the end the following3 7i7 7#a7 7,a7 ,in establishing any quota under this section1 or any procurement quota established by the ,attorney ,general by regulation1 for fentanyl1 oxycodone1 hydrocodone1 oxymorphone1 or hydromorphone 7in this subsection referred to as a covered controlled substance71 the ,attorney ,general shall estimate the amount of diversion of the covered controlled substance that occurs in the ,united ,states4 7,b7 ,in estimating diversion under this paragraph1 the ,attorney ,general-- 7i7 shall consider information the ,attorney ,general1 in consultation with the ,secretary of ,health and ,human ,services1 determines reliable on rates of overdose deaths and abuse and overall public health impact related to the covered controlled substance in the ,united ,states2 and 7ii7 may take into consideration whatever other sources of information the ,attorney ,general determines reliable4 7,c7 ,after estimating the amount of diversion of a covered controlled substance1 the ,attorney ,general shall make appropriate quota reductions1 as determined by the ,attorney ,general1 from the quota the ,attorney ,general would have otherwise established had such diversion not been considered4 7#b7 7,a7 ,for any year for which the approved aggregate production quota for a covered controlled substance is higher than the approved aggregate production quota for the covered controlled substance for the previous year1 the ,attorney ,general shall include in the final order an explanation of why the public health benefits of increasing the quota clearly outweigh the consequences of having an increased volume of the covered controlled substance available for sale1 and potential diversion1 in the ,united ,states4 7,b7 ,not later than #a year after the date of enactment of this subsection1 and every year thereafter1 the ,attorney ,general shall submit to the ,caucus on ,international ,narcotics ,control1 the ,committee on the ,judiciary1 the ,committee on ,health1 ,education1 ,labor1 and ,pensions1 and the ,committee on ,appropriations of the ,senate and the ,committee on the ,judiciary1 the ,committee on ,energy and ,commerce1 and the ,committee on ,appropriations of the ,house of ,representatives the following information with regard to each covered controlled substance3 7i7 ,an anonymized count of the total number of manufacturers issued individual manufacturing quotas that year for the covered controlled substance4 7ii7 ,an anonymized count of how many such manufacturers were issued an approved manufacturing quota that was higher than the quota issued to that manufacturer for the covered controlled substance in the previous year4 7#c7 ,not later than #a year after the date of enactment of this subsection1 the ,attorney ,general shall submit to ,congress a report on how the ,attorney ,general1 when fixing and adjusting production and manufacturing quotas under this section for covered controlled substances1 will-- 7,a7 take into consideration changes in the accepted medical use of the covered controlled substances2 and 7,b7 work with the ,secretary of ,health and ,human ,services on methods to appropriately and anonymously estimate the type and amount of covered controlled substances that are submitted for collection from approved drug collection receptacles1 mail-back programs1 and take-back events4 4 7b7 ,conforming change ,the ,law ,revision ,counsel is directed to amend the heading for subsection 7b7 of section #hbf of title #ba1 ,united ,states ,code1 by striking production and inserting manufacturing4 ,f ,preventing ,drug ,diversion #cfja4 ,short title ,this subtitle may be cited as the ,preventing ,drug ,diversion ,act of #bjah4 #cfjb4 ,improvements to prevent drug diversion 7a7 ,definition ,section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7 is amended by adding at the end the following3 7#eg7 ,the term suspicious order includes-- 7,a7 an order of a controlled substance of unusual size2 7,b7 an order of a controlled substance deviating substantially from a normal pattern2 7,c7 orders of controlled substances of unusual frequency2 and 7,d7 an order having any characteristic that would indicate to a reasonable registrant that it is suspicious or not legitimate4 4 7b7 ,suspicious orders ,part ,c of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hba et seq47 is amended by adding at the end the following3 #cab4 ,suspicious orders 7a7 ,reporting ,each registrant shall-- 7#a7 design and operate a system to identify suspicious orders for the registrant2 7#b7 ensure that the system designed and operated under paragraph 7#a7 by the registrant complies with applicable ,federal and ,state privacy laws2 and 7#c7 upon discovering a suspicious order or series of orders1 notify the ,administrator of the ,drug ,enforcement ,administration and the ,special ,agent in ,charge of the ,division ,office of the ,drug ,enforcement ,administration for the area in which the registrant is located or conducts business4 7b7 ,suspicious order database 7#a7 ,in general ,not later than #a year after the date of enactment of this section1 the ,attorney ,general shall establish a centralized database for collecting reports of suspicious orders4 7#b7 ,satisfaction of reporting requirements ,if a registrant reports a suspicious order to the centralized database established under paragraph 7#a71 the registrant shall be considered to have complied with the requirement under subsection 7a77#c7 to notify the ,administrator of the ,drug ,enforcement ,administration and the ,special ,agent in ,charge of the ,division ,office of the ,drug ,enforcement ,administration for the area in which the registrant is located or conducts business4 7c7 ,sharing information with the ,states 7#a7 ,in general ,the ,attorney ,general shall prepare and make available information regarding suspicious orders in a ,state1 including information in the database established under subsection 7b77#a71 to the point of contact for purposes of administrative1 civil1 and criminal oversight relating to the diversion of controlled substances for the ,state1 as designated by the ,governor or chief executive officer of the ,state4 7#b7 ,timing ,the ,attorney ,general shall provide information in accordance with paragraph 7#a7 within a reasonable period of time after obtaining the information4 7#c7 ,coordination ,in establishing the process for the provision of information under this subsection1 the ,attorney ,general shall coordinate with ,states to ensure that the ,attorney ,general has access to information1 as permitted under ,state law1 possessed by the ,states relating to prescriptions for controlled substances that will assist in enforcing ,federal law4 4 7c7 ,reports to ,congress 7#a7 ,definition ,in this subsection1 the term suspicious order has the meaning given that term in section #ajb of the ,controlled ,substances ,act1 as amended by this subtitle4 7#b7 ,one time report ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall submit to ,congress a report on the reporting of suspicious orders1 which shall include-- 7,a7 a description of the centralized database established under section #cab of the ,controlled ,substances ,act1 as added by this section1 to collect reports of suspicious orders2 7,b7 a description of the system and reports established under section #cab of the ,controlled ,substances ,act1 as added by this section1 to share information with ,states2 7,c7 information regarding how the ,attorney ,general used reports of suspicious orders before the date of enactment of this ,act and after the date of enactment of this ,act1 including how the ,attorney ,general received the reports and what actions were taken in response to the reports2 and 7,d7 descriptions of the data analyses conducted on reports of suspicious orders to identify1 analyze1 and stop suspicious activity4 7#c7 ,additional reports ,not later than #a year after the date of enactment of this ,act1 and annually thereafter until the date that is #e years after the date of enactment of this ,act1 the ,attorney ,general shall submit to ,congress a report providing1 for the previous year-- 7,a7 the number of reports of suspicious orders2 7,b7 a summary of actions taken in response to reports1 in the aggregate1 of suspicious orders2 and 7,c7 a description of the information shared with ,states based on reports of suspicious orders4 7#d7 ,one time ,,gao report ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states1 in consultation with the ,administrator of the ,drug ,enforcement ,administration1 shall submit to ,congress a report on the reporting of suspicious orders1 which shall include an evaluation of the utility of real-time reporting of potential suspicious orders of opioids on a national level using computerized algorithms1 including the extent to which such algorithms-- 7,a7 would help ensure that potentially suspicious orders are more accurately captured1 identified1 and reported in real-time to suppliers before orders are filled2 7,b7 may produce false positives of suspicious order reports that could result in market disruptions for legitimate orders of opioids2 and 7,c7 would reduce the overall length of an investigation that prevents the diversion of suspicious orders of opioids4 ,g ,sense of ,congress #cgja4 ,sense of ,congress ,it is the sense of ,congress that3 7#a7 ,americans with substance use disorders often seek treatment through recovery homes and clinical treatment facilities that offer detoxification1 risk reduction1 outpatient treatment1 residential treatment1 or rehabilitation for substance use4 ,most of those facilities provide a critical function in addressing substance misuse and abuse1 particularly as the incidence and prevalence of substance use disorders1 and drug overdose numbers continue to rise4 7#b7 ,despite the necessity of such treatment facilities and the important services most provide1 there are some bad actors in the industry who1 through telemarketing and other schemes1 actively recruit patients with private insurance so that programs can bill the insurers without providing the necessary treatment services4 ,often these patient brokers are paid for each patient successfully recruited4 ,payments are also made as a percentage of billings1 which incentivizes brokers to recommend patients even at low risk levels to the most aggressive and most expensive treatment programs4 7#c7 ,unless the patient is enrolled in a ,federal health care program1 a gap in ,federal law exists with respect to patient brokers who are improperly recruiting unsuspecting patients to defraud insurance companies4 7#d7 ,it is important that ,congress provide a mechanism to penalize these bad actors1 while minding legitimate entities who continue to help patients find reputable treatment programs4 ,,iv ,commerce ,a ,fighting ,opioid ,abuse in ,transportation #daja4 ,short title ,this subtitle may be cited as the ,fighting ,opioid ,abuse in ,transportation ,act4 #dajb4 ,rail mechanical employee controlled substances and alcohol testing 7a7 ,rail mechanical employees ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,transportation shall publish a final rule in the ,federal ,register revising the regulations promulgated under section #bjadj of title #di1 ,united ,states ,code1 to designate a rail mechanical employee as a railroad employee responsible for safety-sensitive functions for purposes of that section4 7b7 ,definition of rail mechanical employee ,the ,secretary shall define the term rail mechanical employee by regulation under subsection 7a74 7c7 ,savings clause ,nothing in this section may be construed as limiting or otherwise affecting the discretion of the ,secretary of ,transportation to set different requirements by railroad size or other factors1 consistent with applicable law4 #dajc4 ,rail yardmaster controlled substances and alcohol testing 7a7 ,yardmasters ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,transportation shall publish a final rule in the ,federal ,register revising the regulations promulgated under section #bjadj of title #di1 ,united ,states ,code1 to designate a yardmaster as a railroad employee responsible for safety-sensitive functions for purposes of that section4 7b7 ,definition of yardmaster ,the ,secretary shall define the term yardmaster by regulation under subsection 7a74 7c7 ,savings clause ,nothing in this section may be construed as limiting or otherwise affecting the discretion of the ,secretary of ,transportation to set different requirements by railroad size or other factors1 consistent with applicable law4 #dajd4 ,department of ,transportation public drug and alcohol testing database 7a7 ,in general ,subject to subsection 7c71 the ,secretary of ,transportation shall-- 7#a7 not later than ,march #ca1 #bjai1 establish and make publicly available on its website a database of the drug and alcohol testing data reported by employers for each mode of transportation2 and 7#b7 update the database annually4 7b7 ,contents ,the database under subsection 7a7 shall include1 for each mode of transportation-- 7#a7 the total number of drug and alcohol tests by type of substance tested2 7#b7 the drug and alcohol test results by type of substance tested2 7#c7 the reason for the drug or alcohol test1 such as pre-employment1 random1 post-accident1 reasonable suspicion or cause1 return-to-duty1 or follow-up1 by type of substance tested2 and 7#d7 the number of individuals who refused testing4 7c7 ,commercially sensitive data ,the ,department of ,transportation shall not release any commercially sensitive data furnished by an employer under this section unless the data is aggregated or otherwise in a form that does not identify the employer providing the data4 7d7 ,savings clause ,nothing in this section may be construed as limiting or otherwise affecting the requirements of the ,secretary of ,transportation to adhere to requirements applicable to confidential business information and sensitive security information1 consistent with applicable law4 #daje4 ,,gao report on ,department of ,transportation's collection and use of drug and alcohol testing data 7a7 ,in general ,not later than #b years after the date the ,department of ,transportation public drug and alcohol testing database is established under section #dajd1 the ,comptroller ,general of the ,united ,states shall-- 7#a7 review the ,department of ,transportation ,drug and ,alcohol ,testing ,management ,information ,system2 and 7#b7 submit to the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate and the ,committee on ,transportation and ,infrastructure of the ,house of ,representatives a report on the review1 including recommendations under subsection 7c74 7b7 ,contents ,the report under subsection 7a7 shall include-- 7#a7 a description of the process the ,department of ,transportation uses to collect and record drug and alcohol testing data submitted by employers for each mode of transportation2 7#b7 an assessment of whether and1 if so1 how the ,department of ,transportation uses the data described in paragraph 7#a7 in carrying out its responsibilities2 and 7#c7 an assessment of the ,department of ,transportation public drug and alcohol testing database under section #dajd4 7c7 ,recommendations ,the report under subsection 7a7 may include recommendations regarding-- 7#a7 how the ,department of ,transportation can best use the data described in subsection 7b77#a72 7#b7 any improvements that could be made to the process described in subsection 7b77#a72 7#c7 whether and1 if so1 how the ,department of ,transportation public drug and alcohol testing database under section #dajd could be made more effective2 and 7#d7 such other recommendations as the ,comptroller ,general considers appropriate4 #dajf4 ,transportation ,workplace ,drug and ,alcohol ,testing ,program2 addition of fentanyl 7a7 ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs 7#a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall determine whether a revision of the ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs to expand the opioid category on the list of authorized drug testing to include fentanyl is justified1 based on the reliability and cost-effectiveness of available testing4 7#b7 ,revision of guidelines ,if the expansion of the opioid category is determined to be justified under paragraph 7#a71 the ,secretary of ,health and ,human ,services shall-- 7,a7 notify the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate and the ,committee on ,transportation and ,infrastructure of the ,house of ,representatives of the determination2 and 7,b7 publish in the ,federal ,register1 not later than #ah months after the date of the determination under that paragraph1 a final notice of the revision of the ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs to expand the opioid category on the list of authorized drug testing to include fentanyl4 7#c7 ,report ,if the expansion of the opioid category is determined not to be justified under paragraph 7#a71 the ,secretary of ,health and ,human ,services shall submit to the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate and the ,committee on ,transportation and ,infrastructure of the ,house of ,representatives a report explaining1 in detail1 the reasons the expansion of the opioid category on the list of authorized drugs to include fentanyl is not justified4 7b7 ,department of ,transportation drug-testing panel ,if the expansion of the opioid category is determined to be justified under subsection 7a77#a71 the ,secretary of ,transportation shall publish in the ,federal ,register1 not later than #ah months after the date the final notice is published under subsection 7a77#b71 a final rule revising part #dj of title #di1 ,code of ,federal ,regulations1 to include fentanyl in the ,department of ,transportation's drug-testing panel1 consistent with the ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs as revised by the ,secretary of ,health and ,human ,services under subsection 7a74 7c7 ,savings provision ,nothing in this section may be construed as-- 7#a7 delaying the publication of the notices described in sections #dajg and #dajh until the ,secretary of ,health and ,human ,services makes a determination or publishes a notice under this section2 or 7#b7 limiting or otherwise affecting any authority of the ,secretary of ,health and ,human ,services or the ,secretary of ,transportation to expand the list of authorized drug testing to include an additional substance4 #dajg4 ,status reports on hair testing guidelines 7a7 ,in general ,not later than #cj days after the date of enactment of this ,act1 and every #ahj days thereafter until the date that the ,secretary of ,health and ,human ,services publishes in the ,federal ,register a final notice of scientific and technical guidelines for hair testing in accordance with section #edjb7;b7 of the ,fixing ,america's ,surface ,transportation ,act 7,public ,law #aad-id2 #abi ,stat4 #acab71 the ,secretary of ,health and ,human ,services shall submit to the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate and the ,committee on ,transportation and ,infrastructure of the ,house of ,representatives a report on-- 7#a7 the status of the hair testing guidelines2 7#b7 an explanation for why the hair testing guidelines have not been issued2 7#c7 a schedule1 including benchmarks1 for the completion of the hair testing guidelines2 and 7#d7 an estimated date of completion of the hair testing guidelines4 7b7 ,requirement ,to the extent practicable and consistent with the objective of the hair testing described in subsection 7a7 to detect illegal or unauthorized use of substances by the individual being tested1 the final notice of scientific and technical guidelines under that subsection1 as determined by the ,secretary of ,health and ,human ,services1 shall eliminate the risk of positive test results of the individual being tested caused solely by the drug use of others and not caused by the drug use of the individual being tested4 #dajh4 ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs ,using ,oral ,fluid 7a7 ,deadline ,not later than ,december #ca1 #bjah1 the ,secretary of ,health and ,human ,services shall publish in the ,federal ,register a final notice of the ,mandatory ,guidelines for ,federal ,workplace ,drug ,testing ,programs using ,oral ,fluid1 based on the notice of proposed mandatory guidelines published in the ,federal ,register on ,may #ae1 #bjae 7#hj ,fed4 ,reg4 #bhjed74 7b7 ,requirement ,to the extent practicable and consistent with the objective of the testing described in subsection 7a7 to detect illegal or unauthorized use of substances by the individual being tested1 the final notice of scientific and technical guidelines under that subsection1 as determined by the ,secretary of ,health and ,human ,services1 shall eliminate the risk of positive test results of the individual being tested caused solely by the drug use of others and not caused by the drug use of the individual being tested4 7c7 ,rule of construction ,nothing in this section may be construed as requiring the ,secretary of ,health and ,human ,services to reissue a notice of proposed mandatory guidelines to carry out subsection 7a74 #daji4 ,electronic recordkeeping 7a7 ,deadline ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall-- 7#a7 ensure that each certified laboratory that requests approval for the use of completely paperless electronic ,federal ,drug ,testing ,custody and ,control ,forms from the ,national ,laboratory ,certification ,program's ,electronic ,custody and ,control ,form systems receives approval for those completely paperless electronic forms instead of forms that include any combination of electronic traditional handwritten signatures executed on paper forms2 and 7#b7 establish a deadline for a certified laboratory to request approval under paragraph 7#a74 7b7 ,savings clause ,nothing in this section may be construed as limiting or otherwise affecting any authority of the ,secretary of ,health and ,human ,services to grant approval to a certified laboratory for use of completely paperless electronic ,federal ,drug ,testing ,custody and ,control ,forms1 including to grant approval outside of the process under subsection 7a74 7c7 ,electronic signatures ,not later than #ah months after the date of the deadline under subsection 7a77#b71 the ,secretary of ,transportation shall issue a final rule revising part #dj of title #di1 ,code of ,federal ,regulations1 to authorize1 to the extent practicable1 the use of electronic signatures or digital signatures executed to electronic forms instead of traditional handwritten signatures executed on paper forms4 #daaj4 ,status reports on ,commercial ,driver's ,license ,drug and ,alcohol ,clearinghouse 7a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 and biannually thereafter until the compliance date1 the ,administrator of the ,federal ,motor ,carrier ,safety ,administration shall submit to the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate and the ,committee on ,transportation and ,infrastructure of the ,house of ,representatives a status report on implementation of the final rule for the ,commercial ,driver's ,license ,drug and ,alcohol ,clearinghouse 7#ha ,fed4 ,reg4 #hgfhf71 including-- 7#a7 an updated schedule1 including benchmarks1 for implementing the final rule as soon as practicable1 but not later than the compliance date2 and 7#b7 a description of each action the ,federal ,motor ,carrier ,safety ,administration is taking to implement the final rule before the compliance date4 7b7 ,definition of compliance date ,in this section1 the term compliance date means the earlier of-- 7#a7 ,january #f1 #bjbj2 or 7#b7 the date that the national clearinghouse required under section #cacjf;a of title #di1 ,united ,states ,code1 is operational4 ,b ,opioid ,addiction ,recovery ,fraud ,prevention #dbja4 ,short title ,this subtitle may be cited as the ,opioid ,addiction ,recovery ,fraud ,prevention ,act of #bjah4 #dbjb4 ,definitions ,in this subtitle3 7#a7 ,opioid treatment product ,the term opioid treatment product means a product1 including any supplement or medication1 for use or marketed for use in the treatment1 cure1 or prevention of an opioid use disorder4 7#b7 ,opioid treatment program ,the term opioid treatment program means a program that provides treatment for people diagnosed with1 having1 or purporting to have an opioid use disorder4 7#c7 ,opioid use disorder ,the term opioid use disorder means a cluster of cognitive1 behavioral1 or physiological symptoms in which the individual continues use of opioids despite significant opioid-induced problems1 such as adverse health effects4 #dbjc4 ,false or misleading representations with respect to opioid treatment programs and products 7a7 ,unlawful activity ,it is unlawful to make any deceptive representation with respect to the cost1 price1 efficacy1 performance1 benefit1 risk1 or safety of any opioid treatment program or opioid treatment product4 7b7 ,enforcement by the ,federal ,trade ,commission 7#a7 ,unfair or deceptive acts or practices ,a violation of subsection 7a7 shall be treated as a violation of a rule under section #ah of the ,federal ,trade ,commission ,act 7#ae ,u4,s4,c4 #eg;a7 regarding unfair or deceptive acts or practices4 7#b7 ,powers of the ,federal ,trade ,commission 7,a7 ,in general ,the ,federal ,trade ,commission shall enforce this section in the same manner1 by the same means1 and with the same jurisdiction1 powers1 and duties as though all applicable terms and provisions of the ,federal ,trade ,commission ,act 7#ae ,u4,s4,c4 #da et seq47 were incorporated into and made a part of this section4 7,b7 ,privileges and immunities ,any person who violates subsection 7a7 shall be subject to the penalties and entitled to the privileges and immunities provided in the ,federal ,trade ,commission ,act as though all applicable terms and provisions of the ,federal ,trade ,commission ,act 7#ae ,u4,s4,c4 #da et seq47 were incorporated and made part of this section4 7c7 ,enforcement by ,states 7#a7 ,in general ,except as provided in paragraph 7#d71 in any case in which the attorney general of a ,state has reason to believe that an interest of the residents of the ,state has been or is threatened or adversely affected by any person who violates subsection 7a71 the attorney general of the ,state1 as parens patriae1 may bring a civil action on behalf of the residents of the ,state in an appropriate district court of the ,united ,states to obtain appropriate relief4 7#b7 ,rights of ,federal ,trade ,commission 7,a7 ,notice to ,federal ,trade ,commission 7i7 ,in general ,except as provided in clause 7iii71 the attorney general of a ,state shall notify the ,federal ,trade ,commission in writing that the attorney general intends to bring a civil action under paragraph 7#a7 before initiating the civil action4 7ii7 ,contents ,the notification required by clause 7i7 with respect to a civil action shall include a copy of the complaint to be filed to initiate the civil action4 7iii7 ,exception ,if it is not feasible for the attorney general of a ,state to provide the notification required by clause 7i7 before initiating a civil action under paragraph 7#a71 the attorney general shall notify the ,federal ,trade ,commission immediately upon instituting the civil action4 7,b7 ,intervention by ,federal ,trade ,commission ,the ,federal ,trade ,commission may-- 7i7 intervene in any civil action brought by the attorney general of a ,state under paragraph 7#a72 and 7ii7 upon intervening-- 7,i7 be heard on all matters arising in the civil action2 and 7,,ii7 file petitions for appeal4 7#c7 ,investigatory powers ,nothing in this subsection shall be construed to prevent the attorney general of a ,state from exercising the powers conferred on the attorney general by the laws of the ,state to conduct investigations1 to administer oaths or affirmations1 or to compel the attendance of witnesses or the production of documentary or other evidence4 7#d7 ,preemptive action by ,federal ,trade ,commission ,if the ,federal ,trade ,commission or the ,attorney ,general on behalf of the ,commission institutes a civil action1 or the ,federal ,trade ,commission institutes an administrative action1 with respect to a violation of subsection 7a71 the attorney general of a ,state may not1 during the pendency of that action1 bring a civil action under paragraph 7#a7 against any defendant or respondent named in the complaint of the ,commission for the violation with respect to which the ,commission instituted such action4 7#e7 ,venue2 service of process 7,a7 ,venue ,any action brought under paragraph 7#a7 may be brought in any district court of the ,united ,states that meets applicable requirements relating to venue under section #acia of title #bh1 ,united ,states ,code4 7,b7 ,service of process ,in an action brought under paragraph 7#a71 process may be served in any district in which the defendant-- 7i7 is an inhabitant2 or 7ii7 may be found4 7#f7 ,actions by other ,state officials ,in addition to civil actions brought by attorneys general under paragraph 7#a71 any other consumer protection officer of a ,state who is authorized by the ,state to do so may bring a civil action under paragraph 7#a71 subject to the same requirements and limitations that apply under this subsection to civil actions brought by attorneys general4 7d7 ,authority preserved ,nothing in this title shall be construed to limit the authority of the ,federal ,trade ,commission or the ,food and ,drug ,administration under any other provision of law4 ,secretary